#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
P
P 1. position; posterior; postpartum; pressure; pulse; pupil. 2. Symbol for the element phosphorus. 3. Symbol for partial
pressure, preferably italicized. 4. Probability.
p page; probability (in statistics); pupil.
p- para- in chemical formulas.
p after- or post-.
P1 first parental generation (in genetics);
first pulmonic heart sound.
P2 pulmonic second sound.
32P
Symbol for radioactive isotope of
phosphorus.
P 0.1 The inspiratory mouth occlusion
pressure measured 0.1 seconds after a
breath initiates. Higher pressures are
found in those mechanically ventilated
patients who are more difficult to wean
from ventilatory support. A more negative pressure implies a patient with an
increased ventilatory demand (shortness of breath) and a less negative pressure means a patient is obtunded or has
weak respiratory muscles.
p53 SEE: under gene.
PA pulmonary artery; physician’s assistant.
Pa 1. Symbol for the element protactinium. 2. Pascal.
P-A, p-a posteroanterior.
P & A percussion and auscultation.
P(A-a)O2 The oxygen pressure gradient
between the alveoli and the arterial
blood.
pabular (păb⬘ū-lăr) [L. pabulum, food]
Pert. to food or nourishment.
pabulum (păb⬘ū-lŭm) [L.] Food or nourishment; esp. in an absorbable solution.
PAC premature atrial contraction.
pacchionian body (păk⬙ē-ō⬘nē-ăn) Arachnoid granulation.
pacchionian depressions Small pits produced on the inner surface of the skull
by protuberance of the pacchionian bodies (arachnoid villi).
PACE (pās) Patient Advise and Consent
Encounter.
pacemaker (pās⬘māk-ĕr) [L. passus, a
step, ⫹ AS. macian, to make] 1. Anything that influences the rate and
rhythm of occurrence of some activity or
process. 2. In cardiology, a specialized
cell or group of cells that automatically
generates impulses that spread to other
regions of the heart. The normal cardiac
pacemaker is the sinoatrial node, a
group of cells in the right atrium near
the entrance of the superior vena cava.
3. A generally accepted term for artificial cardiac pacemaker.
artificial cardiac p. A device that can
trigger mechanical contractions of the
heart by emitting periodic electrical discharges. If the device delivers electricity
through the chest wall, it is called a
transcutaneous pacemaker; if it works
via electrodes inserted inside the body,
it is called an internal or implantable
pacemaker. Pacemakers are used most
often to treat patients with symptomatic slow heart rates or long pauses
between heart beats (e.g., patients with
third-degree heart block, symptomatic
second-degree heart block, bifascicular
block with first-degree heart block, carotid sinus hypersensitivity, and tachybrady syndrome) and slow ventricular
response rates. Occasionally, though,
they also are used for other purposes,
such as to capture and override some
tachyarrhythmias. SEE: illus.
PACEMAKER
Pacemaker defibrillator beneath the skin
All artificial cardiac pacemakers have
a pulse generator (a device that gives off
an electrical impulse at prescribed intervals), electrical leads (which transmit the impulse to the myocardium),
and a battery (usually made of lithium
iodide) encased in titanium and implanted surgically in a subcutaneous
pocket (usually in the chest). The pacing
leads are threaded through a subclavian
vein into the right heart, with the primary lead placed in the ventricle, and
the second lead (if required) in the
atrium. For biventricular pacing, a
third lead is placed in the left ventricle.
A biventricular pacemaker also may
have a built-in cardiovertor-defibrillator. Pacemakers typically have the ability to pace the ventricle, the atrium, or
both; to sense electrical discharges coming from cardiac chambers; and to respond to sensed beats. Most pacemakers in the U.S. also are programmable,
and many are rate responsive. The fea-
short
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pacemaker
1676
tures of each pacemaker are identified
in its three- to five-letter NASPE/BPG
code (developed and revised by the
North American Society of Pacing &
Electrophysiology and the British Pacing & Electrophysiology Group). The
five positions describe the pacer’s functions as follows:
1. Chambers
paced
(O⫽none,
A⫽atrium, V⫽ventricle, D⫽dual [atria
and ventricles], S⫽manufacturer’s designation for single [atrium or ventricle];
2. Chambers
sensed
(O⫽none,
A⫽atrium,
V⫽ventricle,
D⫽Dual,
S⫽Single;
3. Response
to
sensed
event
(O⫽none, T⫽triggered, I⫽inhibited,
D⫽dual [inhibited and triggered];
4. Rate
modulation
(O⫽none,
R⫽rate modulation in response to sensor technology;
5. Multisite
pacing
(O⫽none,
A⫽atrium,
V⫽ventricle,
D⫽dual
[atrium and ventricle]).
Thus a pacemaker with the letter I in
position 3 of its code will inhibit firing
when it senses an intrinsic beat but will
pace the cardiac chamber if no beat is
sensed. The letter D in position 5 indicates
that both atria and both ventricles are
paced, with the left and right chambers
stimulated simultaneously to maintain
coordination and thus improve cardiac
output. When the pacemaker has a rate
modulation feature (R in position 4), also
known as an adaptive rate mechanism, it
works to copy the abilities of a normally
functioning heart, such as detecting exercise and triggering pacer rate acceleration
to meet the increased metabolic need.
Other pacemaker features include hysteresis, which delays unnecessary pacing (which can harm the right ventricle), and allows the patient’s intrinsic
impulse to provide an atrial kick, which
stokes the ventricle and increases cardiac output by 15% to 30% over a beat
without atrial kick. Pacers with a “ratesmoothing algorithm” limit heart rate
changes to a programmed percentage
from one beat to the next, allowing the
heart rate to increase or decrease more
slowly and providing time for the body
to adjust the stroke volume as it would
normally in such situations.
PATIENT CARE: After pacemaker implantation, follow-up care is provided to
ensure that the device is working optimally. A chest x-ray confirms correct
placement of the leads and also can
identify some complications, such as
pneumothorax. Since pacemakers usually are implanted under moderate sedation and analgesia, the patient may
still be drowsy on return to the unit
from recovery; however, he/she should
arouse easily and be able to answer
questions and follow commands. Supplemental oxygen is provided (nasal
pacemaker
top of rh
base of rh
cannula or mask) until the patient is
fully awake and his/her oxygen saturation has returned to baseline. Immobilizing the patient’s shoulder and arm on
the operative side with a sling or acewrap for 24 to 48 hr limits movement
that could dislodge the tip of the pacing
electrode(s) from the endocardial wall,
preventing sensing of intrinsic beats or
needed pacing. The incision is assessed
for bleeding, infection, and incisional
discomfort, which is controlled with prescribed analgesia. The patient also is assessed for chest pain, palpitations, dizziness, shortness of breath, hiccuping,
and a sensation of pacing in the abdomen, and the cardiologist or surgeon notified if any of these occur. The chest xray usually is repeated the following
day to document positioning and rule
out pneumothorax. Pacer function is
checked, and the patient discharged
with instructions for activity restrictions and further care. Follow-up care
typically includes monitoring the pacemaker’s performance, either in the cardiologist’s office or by telephonic link-up
to ensure, for example, that the pulse
generator is triggering a heart rate that
is appropriate for the patient’s needs,
that the leads are working, and that the
battery’s strength is adequate.
Health care professionals should ascertain the type of pacemaker employed
and expectations for its function based
on its NASPE/BPG code; monitor the
cardiac rate and rhythm for evidence of
pacemaker function; assess the patient
for evidence of pacemaker failure or
noncapture (vertigo, loss of consciousness, hypotension, chest discomfort,
dyspnea) and evaluate the patient for
effects on cardiac output; teach the patient technique and rationale for monitoring own pulse rate and for care and
protection of insertion site; and counsel
concerning telephone monitoring checkup, battery replacement, medication
regimen, physical activity, and followup care. They should encourage the patient to wear or carry medical identification and information indicating the
presence and type of pacemaker implanted, along with an electrocardiogram rhythm strip showing pacemaker
activity and capture.
breathing p. A device that stimulates
breathing by delivering electrical pulses
to both phrenic nerves from an external
radio transmitter to an implanted receiver. It is used in patients with quadriplegia or sleep apnea. SEE: radiofrequency electrophrenic respiration.
DDD p. A rate-adaptive implanted
pacing device. It senses and paces both
atrial and ventricular events, triggering
the atrioventricular (AV) interval so
that AV synchrony is maintained over a
wide range of heart rates. This type of
short
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pacemaker
1677
pacing has reduced the incidence of
pacemaker syndrome. It is the most versatile pacing device used. SEE: pacing
code; pacemaker syndrome.
DDI p. An implanted pacing device
that senses both atrial and ventricular
events but can inhibit only atrial impulses. This type of pacing is used only
when atrioventricular conduction is intact. It may be suitable when frequent
atrial tachyarrhythmias cause rapid
ventricular rates.
demand p. An implanted pacemaker
that is designed to permit its electrical
output to be inhibited by the heart’s
electrical impulses. This decreases the
chances for the pacemaker to induce
discomfort or dysrhythmias.
dual-chamber p. A pacemaker that is
also known as an atrioventricular sequential pacemaker because it stimulates both atria and ventricles sequentially.
ectopic p. Any endogenous cardiac
pacemaker other than the sinoatrial
node.
failure of artificial p. A defect in a
pacemaker device caused by either a
failure to sense the patient’s intrinsic
beat or a failure to pace. Failure to pace
can be caused by a worn-out battery,
fracture or displacement of the electrode, or pulse generator defect.
fixed-rate p. A pacemaker that stimulates the heart at a predetermined
rate.
internal p. A cardiac pacemaker
placed within the body.
programmable p. An electronic permanent pacemaker in which one or
more settings can be changed electronically.
rate-responsive p. An electronic pacemaker that senses changes in the body’s
need for adjustment of the cardiac rate
as can occur in sleeping, waking, sitting,
walking, or running. The device alters
cardiac rate by sensing body motion,
changes in breathing, or slight changes
in blood temperature, which improves
the quality of life for active patients. It
is also called a rate-adaptive pacemaker.
temporary p. An electronic device for
temporary cardiac pacing (e.g., during
cardiac surgery and emergencies). The
device consists of an electrode catheter
inserted transvenously in the right ventricular apex that receives impulses
from an external generator.
transcutaneous p. An artificial cardiac pacemaker that is located outside
the body. The electrodes for delivering
the stimulus are located on the chest
wall. SYN: transthoracic pacemaker.
transthoracic p. Transcutaneous p.
wandering p. A cardiac arrhythmia
in which the site of origin of the pacemaker stimulus shifts from one site to
another, usually from the atrioventric-
pachyleptomeningitis
ular node to some other part of the
atrium.
pacemaker syndrome A group of unpleasant symptoms associated with unsynchronized atrioventricular timing in
patients who have single-chamber (ventricular) pacemakers. The symptoms
may include syncope or presyncope, orthostatic dizziness, cough, dyspnea, palpitations, and others. The symptoms
are produced by the contraction of the
atria against closed atrioventricular
valves and by the loss of cardiac output
that the atria would normally contribute to ventricular filling during diastole.
DDD pacing reduces the incidence of
this condition by allowing restoration of
atrioventricular synchrony.
pacer Pacemaker.
pachy-, pach- [Gr. pachys, thick] Combining form meaning thick.
pachycephalic (păk⬙ē-sĕ-făl⬘ı̆k) [⬙ ⫹
kephale, brain] Possessing an abnormally thick skull.
pachycheilia (păk⬙ē-kı̄⬘lē-ă) [⬙ ⫹ cheilos, lip] Unusual thickness of the lips.
pachychromatic (păk⬙ē-krō-măt⬘ı̆k) [⬙
⫹ chroma, color] Possessing a coarse
chromatin network.
pachydactyly, pachydactylia (păk⬙ē-dăktı̆l⬘ē-ă, −dăk⬘tı̆-lē) [⬙ ⫹ daktylos, digit]
A condition marked by unusually large
fingers and toes.
pachyderma
(păk-ē-dĕr⬘mă)
[⬙
⫹
derma, skin] Unusual thickness of the
skin. SEE: elephantiasis.
p. lymphangiectatica A diffuse form
of skin thickening caused by blocked or
defective lymph drainage.
occipital p. A disease in which the
skin of the scalp, esp. in the occipital region, falls into thickened folds.
pachydermatocele (păk⬙ē-dĕr-măt⬘ō-sēl)
[⬙ ⫹ ⬙ ⫹ kele, tumor, swelling] 1. A
pendulous state of the skin with thickening. SYN: cutis laxa; dermatolysis.
2. Huge neurofibroma.
pachydermoperiostosis (păk⬙ē-dĕr⬙mōpĕr⬙ē-ŏs-tō⬘sı̆s) A hereditary form of osteoarthropathy of unknown origin
marked by thickening of the skin over
the face and extremities. If associated
with an underlying disease, treatment
of the disease may cause the symptoms
and signs of this condition to disappear.
pachyglossia (păk⬙ē-glŏs⬘sē-ă) [⬙ ⫹
glossa, tongue] Unusual thickness of
the tongue.
pachygnathous (pă-kı̆g⬘năth-ŭs) [⬙ ⫹
gnathos, jaw] Having a thick or large
jaw.
pachygyria (păk-ē-jı̄⬘rē-ă) [⬙ ⫹ gyros, a
circle] Flat, broad formation of the cerebral convolutions.
pachyleptomeningitis (păk-ē-lĕp⬙tō-mĕn⬙ı̆n-jı̄⬘tı̆s) [⬙ ⫹ leptos, thin, ⫹ meninx,
membrane, ⫹ itis, inflammation] Inflammation of the pia and dura of the
brain and spinal cord.
top of rh
base of rh
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
pachymenia
pacing wire
top of rh
base of rh
(pās⬘ı̆ng) [L. passus, a step]
1. Setting the rate or tempo of an event,
esp. the heartbeat. SEE: pacemaker.
2. Walking forward and back or side to
side without a defined destination. It is
a symptom of anxiety, stress, or of some
people affected by dementia.
asynchronous p. Cardiac pacing set
at a rate independent of the heart’s own
pacemakers. This allows pacemaking at
heart rates that are faster or slower
than the patient’s diseased pacemaker.
epicardial p. Electrical pacing of the
heart by conductive leads inserted surgically, usually during bypass graft or
valvular operations. The leads are used
in the postoperative period for the management of heart blocks or dysrhythmias and are removed as the patient
stabilizes.
overdrive p. Using a pacemaker to
generate a heart rate that is faster than
the spontaneous heart rate of the patient. This is used in attempts to capture and terminate tachycardias or, in
some cases, to try to trigger and study
tachycardias in patients who have suffered them in the past.
synchronous p. Cardiac pacing set
at a rate matching the underlying rate
of one of the heart chambers.
transcutaneous p. The application of
an electrical current between electrodes
placed on the skin to stimulate the heart
to beat. Typically, the electrodes are
placed on the anterior and posterior
chest, or to the right of the sternum and
below the clavicle and on the midaxillary line at the level of the sixth to seventh ribs. Also called external pacing,
noninvasive pacing, external thoracic
pacing, and transchest pacing.
pacing code A code of three to five letters
used for describing pacemaker type and
function. The first letter indicates the
chamber or chambers paced: V for ventricle, A for atrium, or D for dual, i.e.,
for pacing of both chambers. The second
letter, which may also be V, A, or D, indicates the chamber from which electrical activity is sensed. The third letter
indicates the response to the sensed
electrical activity: O indicates no response to the electrical activity sensed;
I, inhibition of the pacing action; T, triggering of the pacemaker function; and
D, that a dual response of spontaneous
atrial and ventricular activity will inhibit atrial and ventricular pacing. The
fourth letter, previously used to describe programmable functions, is now
used to designate variability of the pace
rate with metabolic need. A fifth letter
may indicate antitachycardia-pacing capability, but this is more usually incorporated into automatic implantable defibrillators. SEE: pacemaker; artificial
cardiac pacemaker.
pacing wire Pacemaker electrode.
short
standard
1678
pachymenia (păk-ē-mē⬘nē-ă) [⬙ ⫹ hy-
men, membrane] A thickening of the
skin or membranes.
pachymeningitis (păk-ē-mĕn⬙ı̆n-jı̄⬘tı̆s) [⬙
⫹ meninx, membrane, ⫹ itis, inflammation] Inflammation of the dura mater. SYN: perimeningitis.
pachymeningopathy
(păk⬙ē-mĕn⬙ı̆ngŏp⬘ă-thē) [⬙ ⫹ ⬙ ⫹ pathos, disease]
Any noninflammatory disease of the
dura mater.
pachymeninx (păk-ē-mē⬘nı̆nks) [⬙ ⫹
meninx, membrane] The dura mater.
pachymeter (păk⬘ı̆-mē⬙tĕr) [⬙ ⫹ metron, to measure] A device to determine
the thickness of a material or object,
such as the cornea.
pachymetry (pă-kı̆m⬘ĕ-trē) Measurement of the thickness of a body part,
esp. the thickness of the cornea.
pachyonychia
(păk⬙ē-ō-nı̆k⬘ē-ă)
[Gr.
pachys, thick, ⫹ onyx, nail] Abnormal
thickening of the fingernails or toenails.
p. congenita A congenital condition
characterized by thickening of the nails,
thickening of the skin on the palms of
the hands and the soles of the feet, follicular keratosis at the knees and elbows, and corneal dyskeratosis.
pachyotia (păk-ē-ō⬘shē-ă) [⬙ ⫹ ous, ear]
Abnormal thickness of the ears.
pachypelviperitonitis (păk⬙ē-pĕl⬙vı̆-pĕr⬙ı̆tō-nı̄⬘tı̆s) [⬙ ⫹ L. pelvis, basin, ⫹ Gr.
peritonaion, peritoneum, ⫹ itis, inflammation] Inflammation of the pelvic
and peritoneal membranes with hypertrophy and thickening of their surfaces.
pachyperiostitis (păk⬙ē-pĕr⬙ē-ŏs-tı̄⬘tı̆s) [⬙
⫹ periosteon, periosteum, ⫹ itis, inflammation] Thickening of the periosteum caused by inflammation.
pachyperitonitis (păk⬙ē-pĕr⬙ı̆-tō-nı̄⬘tı̆s) [⬙
⫹ ⬙ ⫹ itis, inflammation] Inflammation of the peritoneum with thickening
of the membrane.
pachypleuritis (păk-ē-plū-rı̄⬘tı̆s) [⬙ ⫹
pleura, side, ⫹ itis, inflammation] Inflammation of the pleura with thickening.
pachypodous (pă-kı̆p⬘ō-dŭs) [⬙ ⫹ pous,
foot] Having abnormally thick feet.
pachytene (păk⬘ē-tēn) [⬙ ⫹ tainia,
band] The stage in meiosis following
zygotene, in which the paired homologous chromosomes become shorter,
thicker, and form tetrads; crossing over
may take place.
pachytrichous (păk⬙ı̆-trı̆k⬘ŭs) Presence
of enlarged hair fibers.
pachyvaginalitis (păk⬙ē-văj⬙ı̆n-ă-lı̄⬘tı̆s) [⬙
⫹ L. vagina, sheath, ⫹ Gr. itis, inflammation] Inflammation of the tunica vaginalis of the testes.
pachyvaginitis
(păk⬙ē-văj⬙ı̆n-ı̄⬘tı̆s)
Chronic inflammation of the vagina
with thickening of the vaginal walls.
pacifier An artificial nipple, usually made
of plastic, provided for infants to satisfy
their need to suck.
pacing
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
pacinian corpuscles
1679
pacinian corpuscles (pă-sı̆n⬘ē-ăn) [Filippo Pacini, It. anatomist, 1812– 1883]
Encapsulated sensory nerve endings
found in subcutaneous tissue and many
other parts of the body (pancreas, penis,
clitoris, nipple). These corpuscles are
sensitive to deep or heavy pressure.
SYN: Vater’s corpuscles.
pack (păk) [AS. pak] 1. A dry or moist,
hot or cold blanket or sheet wrapped
around a patient and used for treatment. 2. To fill up a cavity with cotton,
gauze, or a similar substance.
cold p. 1. A bulky dressing containing icewater, cubed or crushed ice, or
gel, which is refrigerated and used topically to control pain or inflammation.
SYN: ice pack. 2. A rarely used form of
physical restraint, once popular in psychiatric practice. The restless, insomniac, or uncooperative patient was
wrapped in two or more sheets that had
been placed in cold water and wrung out
before application, and then in heavy
blankets to prevent loss of cooling and
evaporation of moisture.
dry p. A procedure that is used in
combination with a hot bath to induce
perspiration. When leaving the hot
bath, the patient is placed in a dry warm
sheet and wrapped in several warm
blankets.
full p. Any pack that enwraps the entire body.
half p. A wet-sheet pack extending
from the axillae to below the knees.
hot p. A type of superficial moist
heat applied to reduce pain and promote
muscle relaxation. The pack is heated to
65⬚ to 90⬚C in hot water. The pack is
then wrapped with terrycloth prior to
application.
ice p. Cold pack.
partial p. A wet pack that covers a
portion of the body.
periodontal p. A surgical dressing
applied over an area involved in periodontal surgery to enhance healing and
tissue recovery. Components may include eugenol, resin, zinc oxide, tannic
acid, cocoa butter, paraffin, olive oil, and
an antibiotic. SYN: periodontal dressing.
wet-dry p. A pack or dressing placed
in a wound or ulcer in order to facilitate
healing or débride necrotic tissues. The
dressing is moistened with the prescribed solution (e.g., sterile saline)
prior to packing the wound. The dressing is then packed into the open wound.
During the next dressing change, the removal of the dried packing débrides the
wound. Alternatives to wet-dry dressings include gels and hydrocolloids,
among others.
wet-sheet p. The envelopment of a
patient in wet sheets or blankets; a
technique formerly used to treat hyperthermia. They are held against the body
pad
top of rh
base of rh
by large woolen blankets. The temperature of the water used for the sheets
varies, depending on the purpose.
package insert An informational leaflet
placed inside the container or package
of prescription drugs. The U.S. Food and
Drug Administration requires that the
drug’s generic name, indications, contraindications, adverse effects, dosage,
and route of administration be described in the leaflet.
packed cells, packed red blood cells
ABBR: PRBCs. Red blood cells that
have been separated from plasma. They
are used to treat conditions such as
hemorrhage or symptomatic anemias
that require transfusions of red blood
cells but not the liquid components of
whole blood. The transfusion of PRBCs
in place of whole blood elevates hemoglobin levels and reduces the likelihood
of fluid overload in the recipient.
packer (păk⬘ĕr) A device for packing a
cavity or a wound.
packing (păk⬘ı̆ng) 1. The process of filling a cavity or wound with gauze
sponges or gauze strips. 2. Material
used to fill a cavity or wound.
pack-year The consumption of a pack of
cigarettes daily for a year (approximately 365 packs of cigarettes annually). The number of pack-years that
people smoke correlates closely with the
amount of damage that tobacco does to
their hearts, lungs, and other organs.
PaCO2 Partial pressure of carbon dioxide
in the arterial blood; arterial carbon dioxide concentration or tension. It is usually expressed in millimeters of mercury
(mm Hg).
pad (păd) 1. A cushion of soft material,
usually cotton or rayon, used to apply
pressure, relieve pressure, or support
an organ or part. 2. A fleshlike or fatty
mass.
abdominal p. A dressing for absorbing discharges from surgical wounds of
the abdomen.
buccal fat p. Sucking p.
dinner p. A pad placed on the abdomen before application of a plaster cast.
The pad is then removed, leaving space
for abdominal distention after meals.
fat p. 1. Sucking p. 2. A layer of adipose tissue (usually capsulated) that
protects structures from direct impact.
Fat pads are found in various locations
in the body: beneath the patellar tendon; under the calcaneus; or behind the
elbow.
kidney p. An air or water pad fixed
on an abdominal belt for compression
over a movable kidney.
knuckle p. A congenital condition in
which small nodules appear on the dorsal side of fingers.
perineal p. A pad covering the perineum; used to cover a wound or to absorb the menstrual flow.
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
pad
pain
top of rh
base of rh
the initial part of the word. SEE: craniopagus.
PAH, PAHA para-aminohippuric acid.
pain (pān) [L. poena, a fine, a penalty,
punishment] As defined by the International Association for the Study of
Pain, an unpleasant sensory and emotional experience arising from actual or
potential tissue damage or described in
terms of such damage. Pain includes not
only the perception of an uncomfortable
stimulus but also the response to that
perception. About half of the persons
who seek medical help do so because of
the primary complaint of pain. Acute
pain occurs with an injury or illness; is
often accompanied by anxiety, diaphoresis, nausea, and vital sign changes
such as tachycardia or hypertension;
and should end after the noxious stimulus is removed or any organ damage
heals. Chronic or persistent pain is discomfort that lasts beyond the normal
healing period. Pain may arise in nearly
any organ system and may have different characteristics in each. Musculoskeletal pain often is exacerbated by
movement and may be accompanied by
joint swelling or muscle spasm. Myofascial pain is marked by trigger-point tenderness. Visceral pain often is diffuse or
vaguely localized, whereas pain from
the lining of body cavities often is localized precisely, very intense, and exquisitely sensitive to palpation or movement. Neuropathic (nerve) pain usually
stings or burns, or may be described as
numbness, tingling, or shooting sensations. Colicky pain fluctuates in intensity from severe to mild, and usually occurs in waves. Referred pain results
when an injury or disease occurs in one
body part but is felt in another.
Several factors influence the experience of pain. Among these are the nature of the injury or illness causing the
symptom, the physical and emotional
health of the patient, the acuity or chronicity of the symptom, the social milieu
and/or cultural upbringing of the patient, neurochemistry, memory, personality, and other features. SEE: table.
SYMPTOMS: Many clinicians use the
mnemonic “COLDER” to aid the diagnosis of painful diseases. They will ask
the patient to describe the Character,
Onset, Location, and Duration of their
painful symptoms, as well as the features that Exacerbate or Relieve it. For
example: The pain of pleurisy typically
is sharp in character, acute in onset, located along the chest wall, and longlasting; it is worsened by deep breathing
or coughing and relieved by analgesics
or holding still. By contrast, the pain of
myocardial ischemia usually is dull or
heavy, gradual in onset, and located
substernally. It may be worsened by ac-
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sucking p. A mass of fat in the
cheeks, esp. well developed in an infant,
aiding sucking. SYN: Bichat’s fat pad;
buccal fat pad.
surgical p. A soft rubber pad with an
apron and inflatable rim for drainage of
escaping fluids; used in surgery and obstetrics.
paed-, paedo- SEE: pedo-.
Paederus (pēd⬘ĕr-ŭs) [NL] A genus of
beetles that contain the toxin pederin.
PAF 1. paroxysmal atrial fibrillation.
2. platelet aggregating factor.
Page kidney (pāj) Compression of a kidney, usually by a hematoma or tumor,
with resulting hypertension.
Paget, Sir James (păj⬘ĕt) British surgeon, 1814– 1899.
extramammary P.’s disease A
plaque with a definite margin found in
the anogenital area and in the axilla. It
is a rare malignant disease and is
treated by surgical excision.
mammary P.’s disease Carcinoma of
the mammary ducts.
P.’s disease A chronic form of osteitis
of unknown cause affecting older people, causing thickening and hypertrophy of the long bones and deformity of
the flat bones. SYN: osteitis deformans.
SYMPTOMS: Symptoms are insidious
in onset and include pain in the lower
limbs (esp. the tibia), frequent fractures, waddling gait, and shortened
stature. The skull often becomes enlarged, and hearing may be affected.
TREATMENT: Common treatments
include bisphosphonate drugs (e.g.,
alendronate and etidronate). Acetaminophen, aspirin, and other nonsteroidal
anti-inflammatory drugs are often used
to control pain.
pagetoid (paj⬘ĕ-toyd) [Paget ⫹ Gr. eidos, form, shape] Similar to Paget’s disease.
Paget-Schreutter syndrome
(păj⬘ĕt
shroy⬘tĕr) Deep venous thrombosis in
the axillary and/or subclavian vein. The
condition is usually recognized in athletes or laborers who use (or overuse)
the upper extremities (e.g., in sports). It
may produce uncomfortable swelling of
the arm with dilation of the superficial
veins. The diagnosis is confirmed with
ultrasonography and treated with anticoagulants, thrombolytic drugs, or surgery. SYN: effort thrombosis.
page turner An assistive technology device for persons with limited or absent
upper extremity movement; used to
turn the pages of a book.
pagophagia (pā⬙gō-fā⬘jē-ă) [Gr. pagos,
frost, ⫹ phagein, to eat] A form of pica
characterized by excessive consumption
of ice or ice drinks. Causally associated
with iron-deficiency anemia.
-pagus [Gr. pagos, thing fixed] A terminal combining form indicating twins
joined together at the site indicated in
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pain
pain
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Usual Adult Doses and Intervals of Drugs for Relief of Pain
Nonopioid Analgesics
Dose, mg *
Interval
Comments
Acetylsalicylic
acid
Acetaminophen
Ibuprofen
Indomethacin
325– 650
4– 24 hr
Enteric-coated preparations available
650
400– 800
25– 75
4 hr
4– 8 hr
8 hr
Naproxen
250– 500
12 hr
15– 60 IM
4– 6 hr
Avoid in liver failure
Available without prescription
Gastrointestinal and kidney side effects common
Delayed effects may be due to long
half-life
Similar to ibuprofen but more potent
Generic Name
Ketorolac
Opioid Analgesics
Generic Name
Codeine
Hydromorphone
Levorphanol
Methadone
Meperidine
Morphine
Morphine, sustained
release
Oxycodone
Parenteral Dose
(mg)
PO Dose (mg)
Comments
30– 60 every 4 hr 30– 60 every 4 hr Nausea common
1– 2 every 4 hr
2– 4 every 4 hr
Shorter acting than
morphine sulfate
2 every 6– 8 hr
4 every 6 hr
Longer acting than
morphine sulfate;
absorbed well PO
10– 100
6– 24 hr
Delayed sedation
due to long halflife
25– 100
300 every 4 hr
Poorly absorbed PO;
normeperidine is
a toxic metabolite
10 every 4 hr
60 every 4 hr
30– 90
60– 180 2 or 3
times daily
—
5– 10 every 4– 6
Usually available
hr
with acetaminophen or aspirin
* By mouth unless indicated otherwise.
PO—by mouth only.
SOURCE: Adapted from Isselbacher, K.J., et al.: Harrison’s Principles of Internal Medicine,
ed 13. McGraw-Hill, New York, 1994.
tivity (but not by taking a breath or
coughing) and relieved by nitroglycerin.
In 2000, the Joint Commission on Accreditation of Healthcare Organizations
(JCAHO) issued pain-management
standards, in 2001 began surveying for
compliance, and in 2004 added patientsafety goals, thus most U.S. health care
facilities have devised policies and procedures that require pain-intensity rating as a routine part of care (the fifth
vital sign). Pain intensity usually is assessed on a numerical scale, in which 0
⫽ no pain, 1 to 3 ⫽ mild pain, 4 to 6 ⫽
moderate pain, and 7 to 10 ⫽ severe
pain. However, obtaining a numerical
rating of pain intensity is possible only
if the patient is able to provide this report of the pain being experienced,
which infants, children, the critically ill,
and cognitively impaired usually are
unable to do. The Wong’ Baker FACES
scale, developed for pediatric use, has
been used successfully in other patient
populations. It uses visual representa-
tions of smiles or grimaces to depict the
level of pain a patient feels.
PATIENT CARE: Health care professionals must be aware that pain in nonverbal patient can easily be overlooked
and must make a conscious effort to ensure that pain in these patients is assessed and treated. Observing subtle
behaviors and being sensitive to contextual clues are two pain methods used by
health care professionals to try to determine when nonverbal patients are in
pain. When this judgment is made, a
trial of pain-relieving medication may
be used. The responses of the patient
and any complications of treatment
should be carefully observed and appropriate changes made in dosing or the
type of analgesic drug as indicated.
Because pain is a subjective and intensely personal problem, sympathetic
care is an important part of its relief. In
addition to administering analgesic
drugs, health care professionals should
use a wide range of techniques to help
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alleviate pain, including local application of cold and heat, tactile stimulation, relaxation techniques, diversion,
and active listening, among others.
acute p. Pain that typically is produced by sudden injury (e.g., fracture)
or illness (e.g., acute infection) and is accompanied by physical signs such as increased heart rate, elevated blood pressure, pupillary dilation, sweating, or
hyperventilation. Depending on the severity of the underlying stimulus, acute
pain may be managed with acetaminophen or anti-inflammatory drugs, immobilization and elevation of the injured body part, or the topical
application of heat or ice. Severe acute
pain, such as that of broken ribs or of an
ischemic part, may require narcotics, often with adjunctive agents like hydroxyzine for relief, or antiemetics. Acute
pain should be managed aggressively.
SEE: Nursing Diagnoses Appendix.
adnexal p. Discomfort arising from
the fallopian tubes and ovaries; usually
due to inflammation, infection, or ectopic pregnancy.
back p. Pain felt in or along the spine
or musculature of the posterior thorax.
It is usually characterized by dull, continuous pain and tenderness in the muscles or their attachments in the lower
lumbar, lumbosacral, or sacroiliac
regions. Back pain is often referred to
the leg or legs, following the distribution
of the sciatic nerve.
ETIOLOGY: Common causes of back
pain include pain caused by muscular or
tendon strain, herniated intervertebral
disk, lumbar spinal stenosis, or spondylolisthesis. Patients with a history of
cancer may have back pain caused by
metastatic tumors to the vertebrae and
should be evaluated to be certain that
damage to the spinal cord is not imminent. Patients with back pain and fever
(esp. those with a history of injection
drug use, tuberculosis, or recent back
surgery) should be evaluated for epidural abscess or osteomyelitis.
TREATMENT: Depending on the underlying cause of the back pain, treatment may include drugs, rest, massage,
physical therapy, chiropractic, stretching exercises, injection therapy, and
surgery, among others. Most nonmalignant causes of back pain improve with
a few days of rest, analgesics, and antiinflammatory drugs, followed by 2 to 4
weeks of anti-inflammatory treatment,
appropriate muscle strengthening, and
patience. Pain caused by an osteoporotic
fracture may prove more debilitating
and longer-lasting. Back pain produced
by a spinal metastasis can improve with
corticosteroids, radiation therapy, intravenous bisphosphonates, and/or surgical decompression. Patients with a
spinal epidural abscess will need surgi-
pain
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cal drainage of the infection and antibiotics.
PATIENT CARE: Prolonged bedrest is
inadvisable in most patients with back
pain. The treatment regimen is explained, implemented, and reinforced.
Factors that precipitate symptoms are
identified and preventive actions are
discussed.
bearing-down p. Rectal pressure
and discomfort occurring during the second stage of labor, related to fetal descent and the woman’s straining efforts
to expel the fetus.
boring p. Piercing, used to describe
pain felt deep within the body.
Brodie’s p. Pain caused near a joint
affected with neuralgia when the skin is
folded near it.
burning p. Pain experienced in heat
burns, superficial skin lesions, herpes
zoster, and circumscribed neuralgias.
central p. Pain due to a lesion in the
central nervous system.
chest p. Discomfort felt in the upper
abdomen, thorax, neck, or shoulders.
Chest pain is one of the most common
potentially serious complaints offered
by patients in emergency departments,
hospitals, outpatient settings, and physicians’ offices. A broad array of diseases
and conditions may cause it, including
(but not limited to) angina pectoris or
myocardial infarction; anxiety and hyperventilation; aortic dissection; costochondritis or injured ribs; cough, pneumonia, pleurisy, pneumothorax, or
pulmonary emboli; esophageal diseases,
such as reflux or esophagitis; gastritis,
duodenitis, or peptic ulcer; and stones in
the biliary tree.
chronic p. 1. Long-lasting discomfort, with episodic exacerbations, that
may be felt in the back, one or more
joints, the pelvis, or other parts of the
body. 2. Pain that lasts more than 3– 6
months. 3. Pain that lasts more than a
month longer than the usual or expected course of an illness. 4. Pain that
returns periodically every few weeks or
months for many years. Chronic pain is
often described by sufferers as being debilitating, intolerable, disabling, or
alienating and may occur without an
easily identifiable cause. Studies have
shown a high correlation between
chronic pain and depression or dysphoria, but it is unclear whether the psychological aspects of chronic pain precede or develop as a result of a person’s
subjective suffering. Chronic pain is the
leading cause of disability in the U.S.
SEE: acute p.; Nursing Diagnoses Appendix.
PATIENT CARE: The management of
chronic, nonmalignant pain is often difficult and may be frustrating for both
sufferer and caregiver. The best results
are usually obtained through multi-
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modal therapy that combines sympathetic
guidance that encourages patients to recover functional abilities, by combinations of drugs (e.g., nonsteroidal antiinflammatories, narcotic analgesics,
and/or antidepressants), physical therapy and regular exercise, occupational
therapy, physiatry, psychological or social counseling, and alternative medical
therapies (e.g., acupuncture, massage,
or relaxation techniques). Placebos, although rarely employed clinically, effectively treat chronic pain in about a third
of all patients. Surgery and other invasive strategies are occasionally employed, with variable effectiveness.
cramplike p. Cramp.
dental p. Pain in the oral area,
which, in general, may be of two origins.
Soft tissue pain may be acute or chronic,
and a burning pain is due to surface lesions and usually can be discretely localized; pulpal pain or tooth pain varies
according to whether it is acute or
chronic, but it is often difficult to localize.
dilating p. Discomfort accompanying
rhythmic uterine contractions during
the first stage of labor.
diskogenic p. Low back pain resulting from degeneration of an intervertebral disk. Discogenic pain differs from
sciatic pain in that it does not radiate
along the course of the sciatic nerve into
the buttocks, hip, or leg.
dull p. A mild discomfort, often difficult to describe, that may be associated
with some musculoskeletal injuries or
some diseases of the visceral organs.
eccentric p. Pain occurring in peripheral structures owing to a lesion involving the posterior roots of the spinal
nerves.
epigastric p. Pain located between
the xiphoid process and the umbilicus.
It may suggest a problem in one of many
different organs, including the stomach,
pancreas, gallbladder, small or large
bowel, pleura, or heart. SYN: gastralgic
pain. SEE: cardialgia.
expulsive p. Discomfort during the
second stage of labor, associated with
bearing-down efforts to expel the fetus.
Women may experience a similar pain
during delivery of the placenta.
false p. Abdominal discomfort associated with Braxton Hicks contractions,
which occur during the last trimester
of pregnancy. Characteristically, the
woman complains of irregular, lower abdominal pains, which are relieved by
walking. Vaginal examination shows no
change in cervical effacement or dilation. SEE: Braxton Hicks contractions.
fulgurant p. Lightning p.
gallbladder p. Biliary colic.
gas p. Pain in the intestines caused
by an accumulation of gas therein.
girdle p. Zonesthesia.
pain
growing p. An imprecise term indicating ill-defined pain, usually in the
shin or other areas of the legs, typically
occurring after bedtime in children age
5 to 12. There is no evidence that the
pain is related to rapid growth or to
emotional problems. If these symptoms
occur during the daytime, are accompanied with other symptoms, or become
progressively more severe, evaluation
for infection, cancer, and other diseases
of muscle and bone should be undertaken. In the majority of cases, this
evaluation is not necessary.
TREATMENT: The child should be reassured and given acetaminophen or
ibuprofen; heat and massage can be applied locally. Children with growing
pains benefit from concern and reassurance from their parents and health care
providers.
heterotopic p. Referred p.
homotopic p. Pain felt at the point
of injury.
inflammatory p. Pain in the presence of inflammation that is increased
by pressure.
intermenstrual p. Episodic, localized
pelvic discomfort that occurs between
menstrual periods, possibly accompanying ovulation. SYN: midpain. SEE:
mittelschmerz.
intractable p. Chronic pain that is
difficult or impossible to manage with
standard
interventions.
Common
causes include metastatic cancer,
chronic pancreatitis, radiculopathy,
spinal cord transection, or peripheral
neuropathy. Intractable pain may also
accompany somatoform disorders, depression, fibromyalgia, irritable bowel
syndrome, and opiate dependence. Various combinations of the following management strategies are often used to
treat intractable pain: antidepressant
medications, counseling, deep brain
stimulation, injected anesthetics, narcotic analgesics, neurological surgery,
and pain clinic consultations.
labor p. Uncomfortable, intermittent, rhythmic, girdling sensations associated with uterine contractions during childbearing. The frequency,
duration, and intensity of the events increase, climaxing with the delivery of
the fetus.
lancinating p. Acute p.
lightning p. A sudden brief pain that
may be repetitive, usually in the legs
but may be at any location. It is associated with tabes dorsalis and other neurological disorders. SYN: fulgurant
pain.
lingual p. Pain in the tongue that
may be due to local lesions, glossitis, fissures, or pernicious anemia. SYN:
tongue pain.
lung p. Sharp pain in the region of
the lungs.
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1684
menstrual p. Dysmenorrhea.
middle p. Intermenstrual p.
mobile p. Pain that moves from one
area to another.
movement p. Kinesalgia.
neuropathic p. Pain that originates
in peripheral nerves or the central nervous system rather than in other damaged organs or tissues. A hallmark of
neuropathic pain is its localization to
specific dermatomes or nerve distributions. Some examples of neuropathic
pain are the pain of shingles (herpes
zoster), diabetic neuropathy, radiculopathy, and phantom limb pain.
TREATMENT: Drugs like gabapentin
or pregabalin provide effective relief of
neuropathic pain for some patients.
Other treatments include (but are not
limited to) regional nerve blocks, selective serotonin and norepinephrine reuptake inhibitors, psychological counseling,
acupuncture, transcutaneous electrical
nerve stimulation, and physical therapy.
night p. Pain that awakens the patient at night or interferes with sleep;
may be due to infection, inflammation,
neurovascular compromise, or severe
structural damage.
objective p. Pain induced by some
external or internal irritant, by inflammation, or by injury to nerves, organs,
or other tissues that interferes with the
function, nutrition, or circulation of the
affected part. It is usually traceable to a
definite pathologic process.
paresthesic p. A stinging or tingling
sensation manifested in central and peripheral nerve lesions. SEE: paresthesia.
periodontal p. A discrete, well-localized pain caused by inflammation of tissues surrounding a tooth. This may be
contrasted with the throbbing, nonlocalized pain typical of a toothache or
pulpal pain.
phantom limb p. The sensation of
pain felt in the nerve distribution of a
body part that has been amputated.
Phantom pain can lead to difficulties in
prosthetic training. SYN: phantom sensation.
PATIENT CARE: Phantom limb pain
or nonpainful sensations are reported
by most amputees. A multimodal or
combination approach to management
is appropriate. Drugs used to treat neuropathic pain may be helpful, including
some anticonvulsant drugs, tricyclic antidepressants, selective serotonin inhibitors, and muscle relaxants. Nerve
blockade and/or transcutaneous electrical stimulation may also be helpful.
Health care professionals should encourage amputees to move the affected
extremity, seek counseling or group
therapy, engage in physical and occupational therapy, and use distraction
techniques.
pain
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postprandial p. Abdominal pain after eating.
precordial p. Pain felt in the center
of the chest (e.g., below the sternum) or
in the left side of the chest.
premonitory p. Ineffective contractions of the uterus before the beginning
of true labor. SEE: false p.
pseudomyelic p. The false sensation
of movement in a paralyzed limb or of
no movement in a moving limb; not a
true pain.
psychogenic p. Pain having mental,
as opposed to organic, origin.
radicular p. Pain that radiates away
from the spinal column through an extremity or the torso resulting from the
compression or irritation of a spinal
nerve root or large paraspinal nerve. It
may be accompanied by numbness or
tingling.
referred p. Pain that arises in one
body part or location but is perceived in
another. For example, pain caused by
inflammation of the diaphragm often is
felt in the shoulder; pain caused by myocardial ischemia may be referred to the
neck or jaw; and pain caused by appendicitis may first be felt near the umbilicus rather than in the right lower quadrant, where the appendix lies. SEE:
table. SYN: heterotopic pain; sympathetic pain. SEE: illus.
remittent p. Pain with temporary
abatements in severity; characteristic of
neuralgia and colic.
rest p. Pain due to ischemia that
comes on when sitting or lying.
root p. Cutaneous pain caused by
disease of the sensory nerve roots.
shooting p. Pain that seems to travel
like lightning from one place to another.
standards for p. relief Standards for
the Relief of Acute Pain and Cancer
Pain developed by the American Pain
Society. These are summarized as follows:
1. In order to increase the clinician’s
responsiveness to complaints of pain, it
is now considered by some health care
professionals to be the fifth vital sign.
2. Acute pain and cancer pain are
recognized and effectively treated. Essential to this process is the development of a clinically useful and easy-touse scale for rating pain and its relief.
Patients will be evaluated according to
the scales and the results recorded as
frequently as needed.
3. Information about analgesics is
readily available. This includes data
concerning the effectiveness of various
agents in controlling pain and the availability of equianalgesic charts wherever
drugs are used for pain.
4. Patients are informed on admission of the availability of methods of relieving pain, and that they must com-
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1685
pain
pain
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Sites of Referred Pain
Organ of Origin
Head
Nose & sinuses
Teeth, gums, tongue
Throat, tonsils
Parotid gland, TMJ joint
Thorax
Diaphragm
Heart
Abdomen
Stomach & spleen
Duodenum
Stomach & spleen
Stomach & spleen
Stomach & spleen
Colon
Appendix
Pelvis
Appendix
Location Felt
External or middle ear
Shoulder, upper abdomen
Upper chest, L shoulder, inside L arm, L jaw
L upper abdomen
Upper abdomen, R shoulder
L upper abdomen
L upper abdomen
L upper abdomen
Lower abdomen
Periumbilical and R lower abdomen
Periumbilical and R lower abdomen
NOTE: L ⫽ left; R ⫽ right.
municate the presence and persistence
of pain to the health care staff.
5. Explicit policies for use of advanced
analgesic technologies are defined. These
advances include patient-controlled analgesia, epidural analgesia, and regional analgesia. Specific instructions concerning
use of these techniques must be available
for the health care staff.
6. Adherence to standards is monitored by an interdisciplinary committee.
The committee is responsible for overseeing the activities related to imple-
menting and evaluating the effectiveness of these pain standards.
starting p. A pain accompanied by
muscular spasm during the early stages
of sleep.
subdiaphragmatic p. A sharp stitchlike pain occurring during breathing
caused, for example, by an abscess or tumor beneath the diaphragm. When the
breath is held, the pain ceases. Pressure
against the lower rib cage eases the pain.
sympathetic p. Referred p.
tenesmic p. Tenesmus.
Gallbladder
Liver
Lungs and diaphragm
Heart
Pancreas
Stomach
Liver
Small intestine
Ovaries
Colon
Bladder
Appendix
Kidneys
Bladder
Ureters
Anterior
Posterior
SITES OF REFERRED PAIN
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palatitis
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ate] Pleasing to the palate or taste, as
food.
palatal (păl⬘ă-tăl) Pert. to the roof of the
mouth, the palate.
palatal expansion appliance A removable
orthodontic appliance equipped to provide
the force for tooth movement. It may be
used continuously or intermittently.
palate (păl⬘ăt) [L. palatum, palate] The
horizontal structure separating the
mouth and the nasal cavity; the roof of
the mouth, supported anteriorly by the
maxillae and palatine bones. SEE:
mouth for illus.
DISEASES AFFECTING THE PALATE:
Koplik’s spots: This rash is frequently
seen on the palate in measles. Secondary syphilis: This is indicated by mucous
patches on the palate. Herpes of the
throat: This is characterized by vesicles
on the pharyngeal walls and soft palate.
Swelling of uvula: This is noted in inflammations of pharynx and tonsil and in
nephritis, severe anemia, and angioneurotic edema. In diphtheria and Vincent’s
angina, a membranous exudate appears.
In some hemorrhagic diatheses, bloody extravasation appears. Kaposi’s sarcoma:
Dark purplish-red lesions may be found
on the hard and soft palate. Paralysis:
This may result from diphtheria, bulbar
paralysis, neuritis, basal meningitis, or a
tumor at the base of the brain. Anesthesia:
This is seen in pathological conditions of
the second division of the fifth nerve.
artificial p. A prosthetic device
molded to fill a cleft in the palate.
bony p. Hard p.
cleft p. A congenital fissure in the
roof of the mouth forming a communicating passageway between mouth and
nasal cavities. It may be unilateral or
bilateral and complete or incomplete.
SYN: palatoschisis.
gothic p. An excessively high palatal
arch.
hard p. The anterior part of the palate supported by the maxillary and palatine bones. SYN: bony palate.
incomplete p. A cleft involving only
a part of the hard or soft palate.
secondary p. In the embryo, the palate formed from the maxillary arches
and frontonasal processes.
soft p. A musculomembranous fold
that partly separates the mouth and the
pharynx; the posterior roof of the
mouth. It is elevated during swallowing
to block the nasopharynx.
palatine
(păl⬘ă-tı̄n)
[L. palatinus]
1. Pert. to the palate. 2. Pert. to the rear
palatal bones.
palatine arches Two archlike folds of mucous membrane (glossopalatine and
pharyngopalatine arches) that form the
lateral margins of faucial and pharyngeal isthmuses. They are continuous
above with the soft palate.
palatitis (păl-ăt-ı̄⬘tı̆s) [L. palatum, pal-
short
standard
1686
terebrant p. A boring or piercing
type of pain.
thalamic p. SEE: thalamic syndrome.
thermalgesic p. Pain caused by heat.
thoracic p. Chest pain.
throbbing p. Pain found in dental
caries, headache, and localized inflammation. The pain is often thought to be
caused by arterial pulsations.
tracheal p. Trachealgia.
vascular p. Pain that throbs or
pulses, such as the pain of a migraine
headache.
wandering p. Pain that changes its
location repeatedly.
pain and suffering Psychological distress
or discomfort experienced as a result of
an injury. Estimates of pain and suffering are used to determine the extent of
a patient’s award in malpractice cases
and the residual disability a patient
may have.
pain disorder A disorder in which pain is
the predominant symptom, is of such severity to warrant clinical attention, and
interferes with function. Psychological
factors are important in the onset, severity, exacerbation, or maintenance of
the pain. The condition is not intentionally produced or feigned.
painful arc During active movement of an
extremity, a portion of the range of motion in which pain is perceived. Pain is
usually due to pinching of soft tissues at
only a specific portion of the range of
motion. A painful arc may be caused by
tendonitis or bursitis.
painful articular syndrome Acute pain affecting the large joints (e.g., the ankles, elbows, knees, and/or shoulders) of those infected with human immunodeficiency
virus (HIV)/acquired immune deficiency
syndrome (AIDS). Its cause is not clearly
defined, but HIV infection of the joints is
thought to be one explanation.
painful bladder syndrome A colloquial,
commonly used term for interstitial nephritis.
paint (pānt) 1. A solution of medication
for application to the skin. 2. To apply a
medicated liquid to the skin.
pain threshold The minimum level of
sensory stimulation that a person will
perceive as being unpleasant, noxious,
or intolerable.
pair Two of anything similar in shape,
size, and conformation.
base p. In the double-stranded helical arrangement of DNA, the purine bases (i.e., base pairs) that are either an
adenine-thymine pair or a guaninecytosine pair. These base pairs connect
the helical strands of DNA like the steps
of a spiral staircase.
ion p. Two particles of opposite charge,
usually an electron and a proton.
PAL posterior axillary line.
palatable (păl⬘ăt-ă-b’l) [L. palatum, pal-
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palatoglossal
1687
ate, ⫹ Gr. itis, inflammation] Inflammation of the palate.
palatoglossal (păl⬙ă-tō-glŏs⬘ăl) Concerning the palate and tongue.
palatoglossus (păl⬙ă-tō-glŏs⬘ŭs) [⬙ ⫹
Gr. glossa, tongue] The muscle arising
from the sides and undersurface of the
tongue. Fibers pass upward through
glossopalatine arch and are inserted in
palatine aponeurosis. It constricts the
faucial isthmus by raising the root of the
tongue and drawing the sides of the soft
palate downward.
palatognathous (păl⬙ă-tŏg⬘nă-thŭs) [⬙
⫹ Gr. gnathos, jaw] Having a congenital cleft in the palate.
palatography (păl⬙ă-tŏg⬘ră-fē) [⬙ ⫹ Gr.
graphein, to write] 1. Recording of the
movements of the palate in speech. 2. Radiographical examination of the soft palate after injection of a contrast medium.
palatopharyngeal (păl⬙ă-tō-fă-rı̆n⬘jē-ăl)
Concerning the palate and pharynx.
palatopharyngeus (păl⬙ăt-ō-fă⬙rı̆n⬘jē-ŭs)
[⬙ ⫹ Gr. pharynx, throat] The muscle
arising from thyroid cartilage and pharyngeal wall, extending upward in posterior pillar, and inserting into aponeurosis of soft palate. It constricts the
pharyngeal isthmus, raises the larynx,
and depresses the soft palate.
palatopharyngoplasty
(păl⬙ă-tō-fărı̆ng⬘gō-plăs⬙tē) Plastic surgical procedure for decreasing the size of the opening
of the nasopharyngeal passageway. It has
been used to treat chronic snoring.
palatoplasty (păl⬘ăt-ō-plăs⬙tē) [⬙ ⫹ Gr.
plassein, to form] Plastic surgery of the
palate, usually to correct a cleft. SEE:
staphylorrhaphy.
palatoplegia (păl⬙ă-tō-plē⬘jē-ă) [⬙ ⫹ Gr.
plege, stroke] Paralysis of muscles of
the soft palate. SEE: palate.
palatorrhaphy (păl-ă-tor⬘ă-fē) [⬙ ⫹ Gr.
rhaphe, seam, ridge] An operation for
uniting a cleft palate. SYN: staphylorrhaphy.
palatosalpingeus (păl⬙ă-tō-săl-pı̆n⬘jē-ŭs)
[⬙ ⫹ Gr. salpinx, tube] The tensor veli
palatini muscle.
palatoschisis (păl-ă-tŏs⬘kı̆-sı̆s) [⬙ ⫹
schisis, a splitting] Cleft palate.
paleocerebellum (păl⬙ē-ō-sĕr⬙ĕ-bĕl⬘ŭm)
[Gr. palaios, old, ⫹ L. cerebellum, little brain] Phylogenetically, the older
portion of the cerebellum including the
flocculi, certain parts of the vermis (lingula, nodulus, uvula), and the lobulus
centralis (culmen, pyramis, uvula, and
simple lobule). These parts are concerned primarily with equilibrium and
coordination of locomotion.
paleokinetic (pā⬙lē-ō-kı̆-nĕt⬘ı̆k) [⬙ ⫹ kinetikos, concerning movement] Regarding a peripheral motor nervous system controlling automatic associated
movements. It is older phylogenetically
than the system controlling voluntary
movement.
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paleopallium (păl⬙ē-ō-păl⬘ē-ŭm) [Gr. pa-
laios, old ⫹ L. pallium, cloak] The
parts of the rhinencephalon that receive
direct input from the olfactory bulb.
paleostriatum (pā⬙lē-ō-strı̄-ā⬘tŭm) An
obsolete term for a part of the striatum
SEE: neostriatum.
pali-, palin- [Gr. palin, backward, again]
Prefixes meaning recurrence, repetition.
palilalia (păl-ı̆-lā⬘lē-ă) [⬙ ⫹ lalein, to
speak] Involuntary repetition of words
or phrases.
palinacousis (păl⬙ı̆n-ă-koo⬘sı̆s) [⬙ ⫹ Gr.
akouein, hear] The perception of repetitive auditory sensations, sometimes
confused with auditory or musical hallucinations. It is usually a symptom of a
lesion such as a tumor or a seizure focus
in the temporal lobe of the brain.
palindromia (păl-ı̆n-drō⬘mē-ă) [⬙ ⫹
dromos, a running] The recurrence of a
disease or a relapse.
palindromic (păl-ı̆n-drŏm⬘ı̆k) Relapsing.
palingraphia (păl⬙ı̆n-grăf⬘ē-ă) [⬙ ⫹
graphein, to write] Pathological repetition of words or phrases in writing.
palinopsia (păl⬙ı̆n-ŏp⬘sē-ă) [⬙ ⫹ opsis,
vision] Persistence of a visual image after the object has been removed. It may
be associated with a lesion in the occipital lobe of the brain. SEE: afterimage.
palladium (pă-lā⬘dē-ŭm) [L.] SYMB:
Pd. A metallic element used in dentistry and surgical instruments; atomic
weight 106.4; atomic number 46.
pallesthesia (păl-ĕs-thē⬘zē-ă) [Gr. pallein, to shake, ⫹ aisthesis, sensation]
The sensation of vibration felt in the
skin or bones, as that produced by a tuning fork held against the body.
palliate (păl⬘ē-āt) [L. palliatus, cloaked]
To ease or reduce effect or intensity, esp.
of a disease; to allay temporarily, as
pain, without curing.
palliation (păl⬙ē-ā⬘shŭn) [L. palliare, to
cloak, conceal] The alleviation of some
aspects of a disease, e.g., the reduction
of the pain and suffering accompanying
an illness.
palliative (păl⬘ē-ā⬙tı̆v) 1. Relieving or alleviating without curing. 2. An agent
that alleviates or eases a painful or uncomfortable condition.
palliative sedation The administration of
sedative and hypnotic drugs to dying
patients to induce coma and alleviate
pain and suffering. It is a technique
used in end-of-life care when other measures to achieve comfort for the dying
patient have failed. Medications such as
barbiturates and opiates are used to
tranquilize the patient. The intent is not
to hasten death, although ultimately,
palliative sedation induces a coma from
which the patient will not awaken.
palliative treatment Treatment designed
to relieve symptoms of disease rather
than to cure it. SEE: table.
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palliative treatment
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Important Considerations in Palliative Care
Communication
How should patients be informed of their illness and prognosis?
Who meets the ongoing information needs of patients and their loved ones?
Symptom Management
Does the patient have pain? How is it to be alleviated?
Does the patient have difficulty breathing?
Does the patient have nausea and/or vomiting?
Does the patient have difficulties with nutrition?
With oral ulcerations or dry mouth?
With constipation or bowel obstruction?
With dehydration?
With incontinence?
With immobility?
With insomnia and other sleep disturbances?
With delirium?
With depression?
With adverse drug reactions?
With excessive sedation?
What techniques will be used to help manage patients with specific illnesses (e.g.,
AIDS, cancer, dementias, heart failure, renal failure, stroke, among others)?
Treatment Issues
Which procedures or treatments would the patient like to have?
Which should patient like to avoid?
How will complementary or alternative therapies be incorporated into management of the illness?
When are transfusions indicated?
What role does chemotherapy, radiotherapy, or surgery play in palliation?
Social Needs
How will family or friends support the patient during the illness?
How will their needs be met?
Will someone be designated to serve as family spokesperson?
How will children learn about the illness, or the impending death of a family
member?
Do patients have culturally specific issues the care team needs to address?
Institutional Issues
Where will palliative care take place? (Home? Day care? Hospice? Nursing home?
Hospital? Prison? Psychiatric institution?)
What staff members will help provide care for the affected person?
How are professional staff educated in the art and science of palliation?
How is continuing education to be provided to staff?
How will errors in palliation be addressed?
What mechanisms are in place for feedback from patients or their loved ones?
For self-criticism by the palliative team?
Legal Issues
What laws or regulations govern the use of palliative methods in the community?
Does the patient have an advanced directive regarding life-sustaining therapies?
Has the patient designated a decision maker to guide palliative efforts, should the
need arise?
Financial Issues
Who pays for care?
How do budget constraints limit or define care?
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palpitate
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Important Considerations in Palliative Care (Continued)
Spiritual Needs
Are the philosophical and/or spiritual needs of the patient being met?
Is the patient having difficulties with existential issues (meaning of life? meaning
of death? imminence of death?)?
Issues at the End of Life
Has the patient expressed an interest in life support? What limits, if any, has the
patient specified?
Has the patient expressed an interest in hospice care?
Has the patient expressed an interest in physician assistance to hasten death?
Issues after Death
How will the grief and bereavement issues of the patient’s closest partners be addressed?
What follow-up will be provided to grieving friends and family?
pallid (păl⬘ı̆d) [L. pallidus, pale] Lacking color, pale, wan.
pallidal (păl⬘ı̆-dăl) Concerning the pallidum of the brain.
pallidectomy (păl⬙ı̆-dĕk⬘tō-mē) [L. pallidum, pallidum, ⫹ Gr. ektome, excision] Surgical, chemical, electrical, or
cryogenic removal or inactivation of the
globus pallidus of the brain.
pallidoansotomy (păl⬙ı̆-dō-ăn-sŏt⬘ō-mē)
[⬙ ⫹ ansa, a handle, ⫹ Gr. tome, incision] Production of lesions in the globus pallidus and ansa lenticularis of the
brain.
pallidotomy (păl⬙ı̆-dŏt⬘ō-mē) [⬙ ⫹ Gr.
tome, incision] Surgical destruction of
the globus pallidus done to treat involuntary movements or muscular rigidity.
The procedure is used experimentally in
treating patients with Parkinson’s disease.
pallidum (păl⬘ı̆-dŭm) [L.] The globus
pallidus of the lenticular nucleus in the
corpus striatum.
pallium (păl⬘ē-ŭm) [L., cloak] The cerebral cortex and its adjacent white
matter.
pallor (păl⬘or) [L.] Lack of color; paleness. SEE: skin.
palm [L. palma, hand] The anterior or
flexor surface of the hand from the wrist
to the fingers. SYN: palma; vola manus.
SEE: thenar.
palmar (păl⬘măr) Concerning the palm
of the hand.
p. cuff Universal cuff.
palmaris (păl-mā⬘rı̆s) One of two muscles, palmaris brevis and palmaris longus.
palmar-plantar erythrodysesthesia A
toxic effect of chemotherapy, characterized by burning or tingling discomfort in
the hands and the soles of the feet occurring after the administration of cancer chemotherapy. Red, violet, and swollen skin may develop on the hands and
feet and may shed, crust, or ulcerate.
Additional cycles of chemotherapy
worsen the effect.
palmature
(păl⬘mă-tūr)
[L. palma,
hand] A pathological condition in
which the fingers are joined or united.
palmitin (păl⬘mı̆-tı̆n) An ester of glycerol
and palmitic acid, derived from fat of
both animal and vegetable origin.
palmoplantar (păl⬙mō-plăn⬘tăr) Pert. to
the palms of the hands and soles of the
feet.
palmus (păl⬘mŭs) [Gr. palmos, pulsation, quivering] 1. Palpitation; a throb.
2. Jerking; a disease with convulsive
nervous twitching of the leg muscles,
similar to jumping. 3. Heartbeat.
palpable (păl⬘pă-b’l) [L. palpabilis,
stroke, touch] Perceptible, esp. by
touch.
palpate (păl⬘pāt) [L. palpare, to touch]
To examine by touch; to feel.
palpation (păl-pā⬘shŭn ) [L. palpatio ]
1. Examination by application of the
hands or fingers to the external surface
of the body to detect evidence of disease
or abnormalities in the internal organs.
2. In obstetrics, a technique used to
evaluate fetal presentation and position; frequency, duration, and strength
of uterine contractions; status of membranes; cervical effacement and dilation; and fetal station.
light-touch p. The process of determining the outline of abdominal organs
by lightly palpating the abdominal wall
with the fingers.
palpatopercussion
(păl⬙pă-tō-pĕrkŭsh⬘ŭn) Palpation combined with percussion.
palpebra (păl⬘pĕ-bră) pl. palpebrae [L.]
An eyelid.
p. inferior The lower eyelid.
p. superior The upper eyelid.
palpebral (păl⬘pĕ-brăl) Concerning an
eyelid.
palpebral muscles 1. Palpebral portion of
the orbicularis oculi. 2. Levator palpebrae superioris.
palpitate (păl⬘pı̆-tāt) [L. palpitatus,
throbbing] 1. To cause to throb. 2. To
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palpitation
throb or beat intensely or rapidly, usually said of the heart.
palpitation (păl-pı̆-tā⬘shŭn) A sensation
of rapid or irregular beating of the
heart. The beating may be described as
a thudding sensation, a fluttering, or a
throbbing that is felt beneath the sternum or in the neck. In clinical practice,
most palpitations are felt by patients
with benign premature ventricular or
atrial contractions. In these patients,
the sensation, although disturbing, is
not associated with serious heart disease. Occasionally palpitations are
caused by sustained arrhythmias, such
as atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia,
or ventricular tachycardia. Electrocardiography, outpatient cardiac monitoring, or cardiology consultation may be
needed to determine whether a patient’s
symptoms are benign or hazardous. pal-
pitant, adj.
arterial p.
Panax japonicus
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ease of the central nervous system that
has its onset in middle age. Conjugate
ocular palsies, dystonia of the neck, and
widespread rigidity occur.
Saturday night p. Paralysis due to
prolonged ischemia of the musculospiral
nerve incident to compressing an arm
against a hard edge. It occurs if the patient has been comatose or in a stupor
or has fallen asleep with the arm hanging over the edge of a bed or chair.
Sometimes called “Saturday night paralysis” because in some cultures individuals traditionally become intoxicated on Saturday night; while
stuporous, they may remain in a position that allows nerve compression.
SYN: musculospiral paralysis; radial
paralysis; Sunday morning paralysis.
scrivener’s p. Writer’s cramp.
wasting p. Spinal muscular atrophy.
Palv Pressure in the alveolus.
PAMP Pathogen-associated molecular
patterns.
pampiniform (păm-pı̆n⬘ı̆-form) [L. pampinus, tendril, ⫹ forma, shape] Convoluted like a tendril.
pan- [Gr.] Combining form indicating
all.
panacea (păn-ă-sē⬘ă) [Gr. panakeia, universal remedy] A remedy for all ills; a
cure-all.
panagglutinable
(păn⬙ă-gloo⬘tı̆-nă-b’l)
[Gr. pan, all, ⫹ L. agglutinare, to glue
to] Referring to blood cells that are agglutinable by every blood group serum
of the species.
panagglutinin (păn⬙ă-glū⬘tı̆n-ı̆n) [Gr.
pan, all, ⫹ L. agglutinare, to glue to]
A substance capable of agglutinizing
corpuscles of every blood group.
panangiitis (păn⬙ăn-jē-ı̄⬘tı̆s) [⬙ ⫹ angeion, vessel, ⫹ itis, inflammation]
Inflammation of all three layers of a
blood vessel (intima, media, and adventitia).
panarteritis (păn⬙ăr-tĕ-rı̄⬘tı̆s) [Gr. pan,
all, ⫹ arteria, artery, ⫹ itis, inflammation] Inflammation of all three layers of an artery (intima, media, and adventitia).
panarthritis (păn⬙ăr-thrı̄⬘tı̆s) [⬙ ⫹ arthron, joint, ⫹ itis, inflammation]
1. Inflammation of all parts of a joint.
2. Inflammation of all or most of the
joints of the body.
panasthenia (păn⬙ăs-thē⬘nē-ă) [⬙ ⫹ astheneia, weakness] Neurasthenia.
panatrophy (păn-ăt⬘rō-fē) [⬙ ⫹ a-, not,
⫹ trophe, nourishment] Localized or
generalized wasting away.
Panax ginseng (păn⬘ăks jı̆n⬘sĕng) [L. fm
Gr., panacea ⫹ ⬙] The scientific name
for Asian ginseng, also known as Chinese or Korean ginseng. This is the ginseng variety used most often in herbal
remedies.
Panax japonicus (jă-pōn⬘ı̆-kŭs, yă-) [NL.,
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Palpitation felt in the
course of an artery.
palpography
(păl-pŏg⬘ră-fē)
[Fm.
palp(ate) ⫹ ⬙] A method of imaging
atherosclerotic plaques with intravascular ultrasonography, in which the
movement of arterial walls in response
to arterial pulse pressure is measured.
The greater the deformation of the arterial wall, the more the strain on the
wall and therefore the greater its soft
lipid content.
PALS (pălz) pediatric advanced life support.
palsy (pawl⬘zē) [ME. palesie, from L. paralysis] Paralysis.
birth p. Birth paralysis.
brachial p. Birth paralysis.
bulbar p. Palsy caused by degeneration of the nuclear cells of the lower cranial nerves. This causes progressive
muscular paralysis.
cerebral p. ABBR: CP. SEE: cerebral palsy.
crutch p. Paralysis resulting from
pressure on nerves in the axilla from
use of a crutch.
diver’s p. Decompression illness.
Erb’s p. Duchenne-Erb paralysis.
facial p. Bell’s palsy.
lead p. Paralysis of the extremities
in lead poisoning.
mercurial p. Paralysis induced by
mercury poisoning.
night p. A form of paresthesia characterized by numbness, esp. at night.
peroneal nerve p. Paralysis of the
peroneal nerve, often caused by automobile accidents in which a pedestrian’s
leg is injured, by fractures of the tibia,
or by other occurrences of nerve disruption or compression. It produces footdrop.
pressure p. Compression paralysis.
progressive supranuclear p. A
chronic progressive degenerative dis-
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Panax quinquefolius
1691
Japanese panacea] The scientific name
for Japanese ginseng.
Panax quinquefolius (kwı̆ng⬙kwĕ-fō⬘lēŭs) [L., five-leaved panacea] The scientific name for American ginseng.
panbronchiolitis, diffuse (păn⬙brŏng-kēō-lı̄⬘tı̆s) [Gr. pan, entire, ⫹ L. bronchiolus, air passage, ⫹ Gr. −itis, inflammation of]
A rare chronic
obstructive lung disease in which small
lung nodules form, sometimes in association with sinus disease. It is typically
found in people of Japanese ancestry.
pancarditis (păn-kăr-dı̄⬘tı̆s) [⬙ ⫹ kardia, heart, ⫹ itis, inflammation] Inflammation of all the structures of the
heart.
panchakarma (păn⬙chă-kăr⬘mă) [Sanskrit pancha, five ⫹ Sanskrit karma
deed] Ayurvedic purification of the intestinal tract by induced vomiting and
the administration of several kinds of
enemas.
Pancoast’s syndrome (păn⬘kōst) [Henry
Khunrath Pancoast, U.S. physician,
1875– 1939] A cluster of signs and
symptoms that include (1) upper extremity or shoulder pain, (2) Horner’s
syndrome, and (3) atrophy of muscle or
bone of the affected arm. It almost always is caused by a malignant neoplasm invading the brachial plexus and
cervical sympathetic nerves. Rarely, it
results from a tubercular or fungal infection of the same nerves.
Pancoast’s tumor A tumor (usually from
lung cancer) that spreads from the superior pulmonary sulcus into the brachial plexus and cervical sympathetic
chain, producing Pancoast’s syndrome.
pancolectomy (păn⬙kō-lĕk⬘tō-mē) [Gr.
pan, all, ⫹ kolon, colon, ⫹ ektome,
excision] Surgical excision of the entire
colon.
pancreas (păn⬘krē-ăs) pl. pancreata [⬙
⫹ kreas, flesh] A compound acinotubular gland located behind the stomach
and in front of the first and second lumbar vertebrae. The head lies within the
curve of the duodenum, the tail lies near
the spleen, and the middle portion constitutes the body. The pancreas is both
an exocrine and an endocrine organ.
The exocrine glands are acini, each with
its own duct; these ducts anastomose to
form the main pancreatic duct or duct of
Wirsung, which joins the common bile
duct and empties into the duodenum at
the hepatopancreatic ampulla. An accessory pancreatic duct or duct of Santorini is often present and opens into the
duodenum directly. Scattered throughout the exocrine glandular tissue are
masses of cells called islets of Langerhans, endocrine glands that secrete hormones. SEE: illus.
FUNCTION: The exocrine secretion of
the pancreas consists of enzymes that
digest food in the small intestine, and
pancreas
sodium bicarbonate to neutralize hydrochloric acid from the stomach in the duodenum. SEE: pancreatic juice.
The islets of Langerhans contain alpha, beta, and delta cells. Alpha cells secrete glucagon, which raises blood glucose; beta cells secrete insulin, which
lowers blood glucose; delta cells secrete
somatostatin, which inhibits the secretion of insulin, glucagon, growth hormone from the anterior pituitary, and
gastrin from the stomach.
DISEASES OF THE PANCREAS: Autoimmune damage to the islets of Langerhans results in type 1 diabetes mellitus,
a disease in which insulin secretion is
insufficient or completely absent. Insulin-secreting tumors of the pancreas,
called insulinomas, produce hypoglycemia; they are exceptionally rare. Inflammation of the pancreas, known as
pancreatitis, is a common condition that
often results from excessive use of alcohol or from obstruction of the exocrine
secretions of the pancreas by gallstones.
Pancreas divisum is a common congenital anomaly in which the main duct of
the exocrine pancreas drains into an accessory pancreatic papilla instead of the
duodenal papilla; it has been associated
with recurring episodes of pancreatitis.
SEE: diabetes mellitus; insulin; pancreatic function test.
accessory p. A small mass of pancreatic tissue close to the pancreas but detached from it.
annular p. An anomalous condition
in which a portion of the pancreas encircles the duodenum.
p. divisum A congenital anomaly in
which the dorsal and ventral pancreatic
ducts fail to unite during embryonic development. It has been associated with
pancreatitis.
dorsal p. A dorsal outpocketing of
the embryonic gut that gives rise to the
body and tail of the adult pancreas.
lesser p. The semidetached lobular
part of the posterior surface of a head of
the pancreas, sometimes having a separate duct opening into the principal
one.
transplantation of the p. The implantation of a part of the pancreas (e.g.,
cells of the islets of Langerhans) or the
entire gland from a donor into a patient
whose own pancreas is no longer functioning. In the diabetic patient, pancreas transplantation provides an endogenous source of insulin and may be
combined with kidney transplantation.
The risks of the surgery and the immunosuppression
associated
with
transplantation must be weighed
against the kidney, nerve, and retinal
damage associated with uncontrolled
diabetes mellitus. Some potential complications of the procedure include infections, blood clotting in the vessels
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1692
pancreas
CYSTIC
DUCT
pancreatic function tests
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HEPATIC DUCTS
FROM LIVER
COMMON
HEPATIC
DUCT
GALLBLADDER
LIVER
COMMON BILE
DUCT
STOMACH
ACCESSORY
PANCREATIC
DUCT
TAIL OF
PANCREAS
LESSER
DUODENAL
PAPILLA
PANCREATIC
DUCT
JEJUNUM
DUODENUM
GREATER
DUODENAL
PAPILLA
(AMPULLA OF
VATER)
HEAD OF
PANCREAS
WALL OF DUODENUM
CUT AWAY TO
REVEAL PAPILLAE
SUPERIOR
MESENTERIC
VEIN
PANCREAS AND ITS RELATIONSHIP TO THE DUODENUM
that supply the graft, hypoglycemia,
bladder injury, and organ rejection. To
prevent rejection, immunosuppressive
drugs, such as tacrolimus, mycophenolate mofetil, cyclosporine, and corticosteroids, may be used. Episodes of rejection are treated with the monoclonal
antibody OKT3. The 1-year survival
rate of combined pancreas-kidney
transplants is about 80%, when performed at institutions where the procedure is done frequently. SEE: diabetes
mellitus; rejection.
ventral p. An outgrowth at the angle
of the hepatic diverticulum and the embryonic gut that migrates and fuses
with the dorsal pancreas. It forms the
head of the definitive organ.
pancreat-, pancreato- Combining forms
meaning pancreas.
pancreatalgia (păn⬙krē-ă-tăl⬘jē-ă) [⬙ ⫹
kreas, flesh, ⫹ algos, pain] Pain in the
pancreas.
pancreatectomy
(păn⬙krē-ă-tĕk⬘tō-mē)
[⬙ ⫹ ⬙ ⫹ ektome, excision] An operation for removal of part or all of the
pancreas. Total pancreatectomy produces diabetes mellitus due to the removal of insulin-producing cells. Exogenous insulin must be administered.
After a subtotal (or partial) pancreatectomy, diabetes may develop some time
later because the remaining islets may
be unable to take care of the increased
demands placed on them. SEE: diabetes.
pancreatic (păn⬙krē-ăt⬘ı̆k) [Gr. pan, all,
⫹ kreas, flesh] Concerning the pancreas.
pancreatic cholera Watery diarrhea, hypokalemia, hypochlorhydria syndrome.
pancreatic function tests Any of several
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pancreatic juice
1693
noninvasive tests used to assess the
health of the exocrine pancreas, typically by assessing the levels of certain
enzymes or digestive products in blood,
feces, or urine. Some examples are the
amino acid consumption test, the NBTPABA test, and the pancreatolauryl
test. None of these tests perfectly reflects pancreatic function.
pancreatic juice A clear, viscid, alkaline
fluid (pH 8.4 to 8.9); its secretion is stimulated by two hormones, secretin and
cholecystokinin, produced by the duodenal mucosa. Pancreatic juice flows
through the main pancreatic duct to the
common bile duct to the duodenum, its
site of action; 500 to 1200 ml is secreted
every 24 hr. It contains sodium bicarbonate and the enzymes trypsinogen,
chymotrypsinogen, amylase, and lipase.
Sodium bicarbonate neutralizes the
acidity of the chyme entering the duodenum from the stomach and prevents
irritation of the duodenal mucosa. Trypsinogen is converted to active trypsin by
intestinal enteropeptidase (enterokinase), and trypsin in turn converts chymotrypsinogen to active chymotrypsin.
Both trypsin and chymotrypsin continue protein digestion, forming peptides. Amylase hydrolyzes starch to
maltose, and lipase digests emulsified
fats to fatty acids and glycerol. SEE: enzyme; pancreas; secretion.
pancreaticocholecystostomy (păn⬙krēăt⬙ı̆-kō-kō⬙lē-sı̆s-tŏs⬘tō-mē) [Gr. pan,
all, ⫹ kreas, flesh, ⫹ chole, bile, ⫹
kystis, bladder, ⫹ stoma, mouth] The
surgical creation of a passage between
the gallbladder and pancreas.
pancreaticoduodenal
(păn⬙krē-ăt⬙ı̆-kōdū-ō-dē⬘năl) [⬙ ⫹ ⬙ ⫹ L. duodeni,
twelve] Concerning the duodenum and
pancreas.
pancreaticoduodenostomy (păn⬙krē-ăt⬙
ı̆-kō-dū⬙ō-dē-nŏs⬘tō-mē) [⬙ ⫹ ⬙ ⫹ ⬙ ⫹
Gr. stoma, mouth] Surgical creation of
an artificial passage between the pancreatic duct or the divided end of the
transected pancreas with the duodenum.
pancreaticoenterostomy (păn⬙krē-ăt⬙ı̆kō-ĕn⬙tĕr-ŏs⬘tō-mē) [⬙ ⫹ ⬙ ⫹ enteron,
intestine, ⫹ stoma, mouth] Surgical
creation of a passage between the pancreatic duct or the transected end of the
pancreas and intestine.
pancreaticogastrostomy (păn⬙krē-ăt⬙ı̆kō-găs-trŏs⬘tō-mē) [⬙ ⫹ ⬙ ⫹ gaster,
belly, ⫹ stoma, mouth] Surgical creation of a passage between the transected end of the pancreas and the stomach. Pancreaticocystogastrostomy is the
anastomosis of pancreatic pseudocyst
and the stomach.
pancreaticojejunostomy (păn⬙krē-ăt⬙ı̆kō-jĕ⬙jū-nŏs⬘tō-mē) [⬙ ⫹ ⬙ ⫹ L. jejunum, empty, ⫹ Gr. stoma, mouth]
pancreatitis
top of rh
base of rh
Surgical creation of a passage between
the pancreatic duct or the transected
end of the pancreas and jejunum.
pancreatin (păn⬘krē-ă-tı̆n) [Gr. pan, all,
⫹ kreas, flesh] 1. One of the enzymes
of the pancreas. 2. A mixture of enzymes, chiefly amylase, lipase, and protease.
ACTION/USES: It is used chiefly in
patients with chronic pancreatitis, who
do not secrete adequate amounts of
their own pancreatic enzymes.
pancreatitis (păn⬙krē-ă-tı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
itis, inflammation] Inflammation of the
pancreas, sometimes accompanied by
damage to neighboring organs such as
the bowel, lungs, spleen, or stomach, or
by a systemic inflammatory response.
SEE: acute p.; chronic p.; Nursing Diagnoses Appendix.
acute p. Pancreatitis of sudden onset, marked clinically by epigastric
pain, nausea, vomiting, and elevated
serum pancreatic enzymes. Varying degrees of pancreatic inflammation, autodigestion, necrosis, hemorrhage, gangrene, or pseudocyst formation may
develop. The disease may be relatively
mild, resolving in 3 or 4 days, or severe
enough to cause multiple organ system
failure, shock, and death (in about 5% of
patients). The patient may assume a sitting or fetal position in attempting to
ease the pain, as lying supine or walking tends to increase discomfort.
ETIOLOGY: Alcohol abuse and obstruction of the pancreatic duct by gallstones are the most common causes of
the disease; less often, pancreatitis results from exposure to drugs (e.g., thiazide diuretics, pentamidine, and many
others), hypertriglyceridemia, hypercalcemia, abdominal trauma, or viral infections (e.g., mumps or coxsackievirus).
TREATMENT: The patient receives
nothing by mouth until pain, nausea,
and vomiting have resolved and diagnostic markers (e.g., serum lipase level)
show evidence of normalizing. Standard
supportive measures include the administration of fluids and electrolytes,
sometimes in massive quantities if dehydration or third-spacing of fluids in
the abdomen occurs.
Refeeding patients before pancreatic inflammation has resolved may
cause a relapse.
PROGNOSIS: Several techniques are
used to determine how well (or how
poorly) patients with pancreatitis will
progress during their illness and
whether they may benefit from intensive care. The best of these is the
APACHE II system; it grades patients
with pancreatitis on the basis of 14 mea-
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
pancreatitis
pancreatolithiasis
top of rh
base of rh
of scar tissue, which leads to malfunction of the pancreas. The disease may be
diagnosed with endoscopic procedures,
with radiographic studies (e.g., x-rays of
the abdomen showing pancreatic calcification), or with so-called tubeless tests
that assess malabsorption caused by
failure of the pancreas to release digestive enzymes into the gastrointestinal
tract.
SYMPTOMS: The pain may be mild or
severe, tending to radiate to the back.
Jaundice, weakness, emaciation, malabsorption of proteins and fats, and diarrhea are present.
gallstone p. Inflammation of the
pancreas, caused by the obstruction of
the ampulla of Vater by a biliary stone.
interstitial p. Pancreatitis with overgrowth of interacinar and intra-acinar
connective tissue.
perilobar p. Fibrosis of the pancreas
between acinous groups.
purulent p. Pancreatitis with abscess formation. SYN: suppurative pancreatitis.
suppurative p. Purulent pancreatitis.
pancreatoduodenectomy (păn⬙krē-ă-tōdū⬙ō-dē-nĕk⬘tō-mē) [Gr. pan, all, ⫹
kreas, flesh, ⫹ L. duodeni, twelve, ⫹
Gr. ektome, excision] Excision of the
head of the pancreas and the adjacent
portion of the duodenum.
pancreatoduodenostomy (păn⬙krē-ă-tōdū⬙ō-dĕ-nŏs⬘tō-mē) [⬙ ⫹ ⬙ ⫹ ⬙ ⫹
stoma, mouth] Surgical anastomosis of
the pancreatic duct, or a pancreatic fistula, to the duodenum.
pancreatogenic, pancreatogenous (păn⬙
krē-ă-tō-jĕn⬘ı̆k, −tŏj⬘ĕ-nŭs) [⬙ ⫹ ⬙ ⫹
gennan, to produce] Produced in or by
the pancreas; originating in the pancreas.
pancreatography
(păn⬙krē-ă-tŏg⬘ră-fē)
[⬙ ⫹ ⬙ ⫹ graphein, to write] Endoscopic and radiological examination of
the pancreas after injection of a radiopaque contrast medium through the
duct of Wirsung.
pancreatolauryl test
(păng⬙krē-ăt⬙ōlŏr⬘ı̆l) A noninvasive test for chronic
pancreatitis in which fluorescein dilaurate is administered orally with a meal.
Patients with chronic pancreatitis secrete diminished amounts of digestive
enzymes into the gastrointestinal tract.
As a result they do not digest foods properly and suffer from malabsorption. In
this test diminished release of exocrine
enzymes by the pancreas results in diminished enzymatic liberation of fluorescein, a decreased uptake of this dye
by the liver, and its diminished excretion in the urine. The test has fair (not
good) sensitivity and specificity for disease diagnosis and is infrequently used.
pancreatolithiasis (păn⬙krē-ă-tō-lı̆-thı̄⬘ă-
short
standard
1694
surable physiological parameters, including the patient’s body temperature,
heart rate, mean arterial pressure, respiratory rate, serum creatinine and sodium levels, arterial pH, white blood
cell count, Glasgow coma scale, and age
(among other factors).
Other methods for determining the
severity of illness in pancreatitis rely on
abnormalities seen on CT imaging or
the measurement of other physiological
criteria, including the serum calcium
and glucose levels, fluid deficit, and
liver function.
PATIENT CARE: Intravenous fluids,
antiemetics, and pain relievers are administered parenterally. A nasogastric
tube may be inserted and placed on low,
intermittent suctioning for patients
with intractable nausea and vomiting or
to reduce hydrochloric acid levels or relieve distention. Required nutritional
support is best provided using jejunal
enteral feedings that maintain gut integrity. These are as effective as parenteral feeding and have the benefit of
reducing the potential for infection and
hypoglycemia. Total parenteral nutrition may be needed for patients with evidence of severe pancreatitis. Such patients may be critically ill. They will
require close monitoring of vital signs,
oxygenation and ventilation, body temperature, cardiac and hemodynamic
status, fluid and electrolytes, balance,
body weight, serum calcium levels, renal function, level of consciousness, peripheral circulation, possible delirium,
and possible multiorgan system failure.
Severe pancreatitis often results in a
prolonged and complicated hospitalization. Throughout the illness, range-ofmotion exercises, correct positioning,
prophylaxis against deep venous thrombosis, oral hygiene, and other physical
support measures prevent debilitation
and complications of prolonged illness.
Both patient and family may need support, especially in the presence of complications (pulmonary, cardiovascular,
renal, immune, and coagulation abnormalities). After pancreatitis has resolved, alcoholic patients should be encouraged to seek help from Alcoholics
Anonymous or other supportive programs. Follow-up with a gastroenterologist, primary care provider, or nutritionist may be helpful during
convalescence and recovery. Patients
should return for prompt re-evaluation
if they have nausea, vomiting, epigastric pain, fevers, or jaundice after discharge.
centrilobar p. Pancreatitis located
around divisions of the pancreatic duct.
chronic p. A form of pancreatitis that
results from repeated or massive pancreatic injury, marked by the formation
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
pancreatolithotomy
1695
sı̆s) [⬙ ⫹ ⬙ ⫹ ⬙ ⫹ −iasis, condition]
Stones in the duct system of the pancreas.
pancreatolithotomy
(păn⬙krē-ăt-ō-lı̆thŏt⬘ō-mē) [⬙ ⫹ ⬙ ⫹ ⬙ ⫹ tome, incision] Incision of the pancreas for removal of a stone.
pancreatolysis (păn⬙krē-ă-tŏl⬘ı̆-sı̆s) [⬙ ⫹
⬙ ⫹ lysis, dissolution] Destruction of
the pancreas by pancreatic enzymes.
pancreatolytic (păn⬙krē-ăt-ō-lı̆t⬘ı̆k) Destructive to pancreatic tissues.
pancreatomy (păn-krē-ăt⬘ō-mē) [⬙ ⫹ ⬙
⫹ tome, incision] Pancreatotomy.
pancreatopathy (păn⬙krē-ă-tŏp⬘ă-thē) [⬙
⫹ ⬙ ⫹ pathos, disease, suffering] Any
pathologic state of the pancreas. SYN:
pancreopathy.
pancreatotomy (păn⬙krē-ă-tŏt⬘ō-mē) [⬙
⫹ ⬙ ⫹ tome, incision] Surgical incision into the pancreas. SYN: pancreatomy.
pancrelipase (păn⬙krē-lı̄⬘pās) A standardized preparation of enzymes, principally lipase, with amylase and protease, obtained from the pancreas of the
hog. It is used in treating conditions associated with deficient secretion from
the pancreas.
pancreolysis (păn⬙krē-ŏl⬘ı̆-sı̆s) [⬙ ⫹ ⬙ ⫹
lysis, dissolution] Enzymatic destruction of the pancreas.
pancreopathy (păn⬙krē-ŏp⬘ă-thē) [⬙ ⫹ ⬙
⫹ pathos, disease, suffering] Pancreatopathy.
pancreoprivic (păn⬙krē-ō-prı̆v⬘ı̆k) Having no pancreas.
pancytopenia (păn⬙sı̄-tō-pē⬘nē-ă) [⬙ ⫹
kytos, cell, ⫹ penia, poverty] A reduction in all cellular elements of the blood.
It is sometimes present in patients with
bone marrow failure, cirrhosis and portal hypertension, or leukemia.
pandemic (păn-dĕm⬘ı̆k) 1. An exceptionally widespread epidemic, that is, a disease or outbreak that affects very high
proportions of the population, or populations throughout the world. 2. Extraordinarily widespread, said, for example, of diseases with global impact,
such as AIDS, the bubonic plague (in
the Middle Ages), or malaria.
pandiculation (păn⬙dı̆k-ū-lā⬘shŭn) [L.
pandiculari, to stretch one’s self]
Stretching of the limbs and yawning, as
on awakening from normal sleep.
panel 1. A number of patients or normal
subjects who participate in medical investigations, esp. studies in which new
drugs, devices, or procedures are tested.
2. A group of patients who obtain their
primary medical care from a single
health care provider.
panel reactive antibody ABBR: PRA. A
measure of an organ transplant recipient’s level of sensitization to antigens on
donated organs. It is the percentage of
cells taken from a broad selection of
panic
top of rh
base of rh
blood donors against whose antigens
the organ recipient’s serum reacts. The
higher the panel reactive antibody, the
more challenging it is to match a donor
organ to the recipient.
panencephalitis
(păn⬙ĕn-sĕf⬙ă-lı̄⬘tı̆s)
[Gr. pan, all, ⫹ enkephalos, brain, ⫹
itis, inflammation] A diffuse inflammation of the brain.
subacute sclerosing p. ABBR:
SSPE. A disease of childhood and adolescence marked by gradual and progressive intellectual and behavioral deterioration followed by seizures, muscle
jerking, gait disturbances, and eventually coma. The illness is a late complication of measles infection (usually developing about 5 years after the child
had measles). It has been almost completely eradicated in the U.S. as a result
of universal measles vaccination. SYN:
Dawson disease.
panendoscope (păn-ĕn⬘dō-skōp) [⬙ ⫹
endon, within, ⫹ skopein, to view] A
cystoscope that gives a wide view of the
bladder.
Paneth cells (pah⬘nĕt) [Josef Paneth,
Ger. physician, 1857– 1890] Large secretory cells containing coarse granules,
found at the blind end of the crypts of
Lieberkühn (the intestinal glands).
They secrete lysozyme.
pang 1. A paroxysm of extreme agony.
2. A sudden attack of any emotion.
panhypopituitarism
(păn-hı̄⬙pō-pı̆-tū⬘ı̆tăr-ı̆zm) [⬙ ⫹ hypo, under, ⫹ L. pituita, mucus, ⫹ Gr. −ismos, condition]
Defective or absent function of the entire pituitary gland. SEE: Simmonds’
disease.
panhysterectomy (păn⬙hı̆s-tĕr-ĕk⬘tō-mē)
[⬙ ⫹ hystera, womb, ⫹ ektome, excision] Excision of the entire uterus including the ovaries, oviducts, and uterine cervix. SEE: hysterectomy.
panhysterocolpectomy
(păn-hı̆s⬙tĕr-ōkŏl-pĕk⬘tō-mē) [⬙ ⫹ ⬙ ⫹ kolpos, vagina, ⫹ ektome, excision] Total excision of the uterus and vagina.
panhystero-oophorectomy (păn-hı̆s⬙tĕrō-ō-ŏf-ō-rĕk⬘tō-mē) [⬙ ⫹ ⬙ ⫹ oophoros, bearing eggs, ⫹ ektome, excision]
Excision of the uterus, cervix, and one
or both ovaries.
panhysterosalpingectomy (păn-hı̆s⬙tĕrō-săl⬙pı̆n-jĕk⬘tō-mē) [⬙ ⫹ ⬙ ⫹ salpinx,
tube, ⫹ ektome, excision] Surgical removal of the uterus, cervix, and fallopian tubes.
panhysterosalpingo-oophorectomy
(păn-hı̆s⬙tĕr-ō-săl⬙pı̆ng-gō-ō-ŏf-ō-rĕk⬘tōmē) [⬙⫹ ⬙ ⫹ ⬙ ⫹ oophoros, bearing
eggs, ⫹ ektome, excision] Excision of
the entire uterus, including the cervix,
ovaries, and uterine tubes.
panic (păn⬘ı̆k) Acute anxiety, terror, or
fright that is usually of sudden onset
and may be uncontrollable. SEE: panic
attack.
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
panic
pansclerosis
top of rh
base of rh
The excision of an apron of abdominal
subcutaneous fat that lacks adequate
supportive tissue from people who are
morbidly obese. Cosmesis can be
achieved by panniculectomy and concomitant abdominoplasty.
panniculitis (păn-ı̆k⬙ū-lı̄⬘tı̆s) [L. panniculus, a small piece of cloth, ⫹ itis, inflammation] Inflammation of subcutaneous fatty tissue. The most common
form of the disease is erythema nodosum.
nodular nonsuppurative p. WeberChristian disease.
panniculus (păn-ı̆k⬘ū-lŭs) [L., a small
piece of cloth] Any clothlike sheet or
layer of tissue.
p. adiposus The subcutaneous layer
of fat; the fat cells in the superficial fascia.
p. carnosus The thin layer of muscle
tissue in the superficial fascia of mammals. SEE: platysma myoides.
pannus (păn⬘nŭs) [L., cloth] 1. Superficial vascular inflammation of the cornea. The area is cloudy, and its surface
is uneven because it is infiltrated with
a film of new capillary blood vessels.
This condition may be seen in trachoma,
acne rosacea, eczema, and as a result of
irritation in granular conjunctivitis.
SEE: micropannus. 2. Inflamed synovial granulation tissue seen in chronic
rheumatoid arthritis.
corneal p. An overgrowth of vascular
tissue in the periphery of the cornea, occurring in response to inflammation of
the cornea, esp. in trachoma.
p. crassus Pannus that is highly vascularized, thick, and opaque.
phlyctenular p. Pannus that occurs
in conjunction with phlyctenular conjunctivitis.
p. siccus Pannus accompanying xerophthalmia. It is composed principally
of connective tissue that is dry and
poorly vascularized.
p. tenuis Pannus that is thin, poorly
vascularized, and slightly opaque.
panodic (pă-nŏd⬘ı̆k) Radiating in all directions, esp. said of a nerve impulse.
panograph (păn⬘ă-grăf⬙) An image made
during panography.
panophthalmia, panophthalmitis (pănŏf-thăl⬘mē-ă, −thăl-mı̄⬘tı̆s) [⬙ ⫹ ophthalmos, eye, ⫹ itis, inflammation]
Inflammation of the entire eye.
panoptic (păn-ŏp⬘tı̆k) [⬙ ⫹ optikos, vision] Making every part visible.
panoramic rotational center (păn-ŏrăm⬘ı̆k) The axis on which the tube
head and cassette of a panoramic x-ray
machine rotate.
panplegia (păn-plē⬘jē-ă) [⬙ ⫹ plege,
stroke] Total paralysis.
pansclerosis (păn⬙sklē-rō⬘sı̆s) [⬙ ⫹
sklerosis, hardening] Hardening of an
entire organ.
short
standard
1696
p. attack A discrete period of intense
fear or discomfort that is accompanied
by at least four of the following symptoms: palpitations, sweating, trembling
or shaking, sensations of shortness of
breath or smothering, feeling of choking, chest pain or discomfort, nausea or
abdominal distress, dizziness or lightheadedness, feeling of unreality or being detached from oneself, feeling of losing control or going crazy, fear of dying,
paresthesias (numbness or tingling sensations), and chills or hot flushes. The
onset is sudden and builds to a peak
usually in 10 min or less. It may include
a sense of imminent danger or impending doom and an urge to escape.
PATIENT CARE: Precautions are
taken to ensure the patient’s safety. A
calm, quiet, and reassuring environment helps the patient to overcome feelings of anxiety. Speaking slowly in
short, simple sentences, giving one direction at a time, and avoiding lengthy
explanations help the patient feel less
overwhelmed. If the patient is hyperventilating, the caregiver demonstrates
slow, deep breathing. Touch may not be
reassuring to the patient and should be
avoided until trust is established. Once
the attack has subsided, the patient is
encouraged to discuss fears and helped
to identify situations or events that act
as triggers for an attack. Relaxation
techniques may be taught, with explanations given regarding using them to
relieve stress or avoid an attack. The patient may be referred for behavioral
therapy, supportive psychotherapy, or
pharmacologic therapy (antianxiety
agents, antidepressants, beta-blockers),
separately or in combination.
p. disorder An anxiety disorder characterized by panic attacks (e.g., agoraphobia with panic attacks).
homosexual p. 1. In Freudian psychiatry, fear, anxiety, aggression, or
psychosis that originates in conflicts
that arise from an attraction to members of one’s own gender. 2. An irrational fear of contracting illnesses from
casual contact with people who have sex
with members of their own gender.
panlobular (păn⬙lŏb⬘ū-lăr) [⬙ ⫹ ⬙] Involving or pertaining to all the lobes of
an organ.
panmyeloid (păn-mı̄⬘ĕ-loyd) [Gr. pan,
all, ⫹ myelos, marrow, ⫹ eidos, form,
shape] Concerning all of the elements
of the bone marrow.
Panner disease (păn⬘ĕr) Osteochondrosis of the capitellum, sometimes associated with avascular necrosis.
panneuritis (păn⬙ū-rı̄⬘tı̆s) [⬙ ⫹ neuron,
sinew, ⫹ itis, inflammation] Generalized neuritis.
p. epidemica Beriberi.
panniculectomy
(pă-nı̆k⬙ū-lĕk⬘tă-mē)
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pansinusitis
1697
pansinusitis (păn⬙sı̄-nŭs-ı̄⬘tı̆s) [⬙ ⫹ L.
sinus, curve, hollow, ⫹ itis, inflammation] Inflammation of all of the
paranasal sinuses.
Panstrongylus (păn-strŏn⬘jı̆-lŭs) A genus of insects belonging to the order
Hemiptera, family Reduviidae. This genus is a vector for Trypanosoma cruzi,
the causative agent of Chagas’ disease
(American trypanosomiasis), a parasitic
illness that causes heart failure and
neural dysfunction.
pansystolic (păn-sı̆s-tŏl⬘ı̆k) Throughout
systole; used to describe the murmur of
mitral regurgitation. SYN: holosystolic.
pant (pănt) [ME. panten] 1. To gasp for
breath. 2. A short and shallow breath.
Panting is produced by physical overexertion, as in running, or from fear.
pant-, panto- [Gr. pantos, all] Combining form indicating all, whole.
pantanencephaly
(păn⬙tăn-ĕn-sĕf⬘ă-lē)
[⬙ ⫹ an-, not, ⫹ enkephalos, brain]
Complete absence of the brain in the fetus.
pantetheine (păn-tĕ-thē⬘ı̆n) The naturally occurring amide of pantothenic
acid. It is a growth factor for Lactobacillus bulgaricus.
panting (pănt⬘ı̆ng) [ME. panten] Short,
shallow, rapid respirations. SYN: polypnea.
pantograph (păn⬘tō-grăf) [Gr. pantos,
all, ⫹ graphein, to write] A device
that will reproduce, through a system of
levers connected to a stylus, a duplicate
of whatever figure or drawing is being
copied by the device.
pantomography
(păn⬙tō-mŏg⬘ră-fē)
Panoramic radiograph.
pantomorphia (păn⬙tō-mor⬘fē-ă) [⬙ ⫹
morphe, form] 1. The state of being
symmetrical. 2. Able to assume any
shape.
Pantopaque (păn-tō⬘păk) An oil-based,
iodine-containing contrast medium
used to outline body structures during
radiographic or fluoroscopic examinations, such as myelograms.
pantothenate (păn-tō⬘thĕn-āt) A salt of
pantothenic acid.
pantothenic
acid
(păn-tō-thĕn⬘ı̆k)
C9H17NO5; a vitamin of the B-complex
group widely distributed in nature, occurring naturally in yeast, liver, heart,
salmon, eggs, and various grains. It was
synthesized in 1940. It is part of coenzyme A, which is necessary for the
Krebs cycle and for conversion of amino
acids and lipids to carbohydrates.
Pan troglodytes troglodytes A subspecies of chimpanzee believed to be the
primary host of human immunodeficiency virus (HIV) before the illness became epidemic in humans.
panuveitis (păn-ū⬙vı̄t⬘ı̆s) Inflammation
that affects all the structures of the eye.
SYN: diffuse uveitis.
Papanicolaou test
top of rh
base of rh
panzootic (păn⬙zō-ŏt⬘ı̆k) [⬙ ⫹ zoon, an-
imal] Any animal disease that is widespread.
PaO The pressure of gases at the opening
of the patient’s airway
PaO2 The partial pressure of oxygen in arterial blood; arterial oxygen concentration, or tension; usually expressed in
millimeters of mercury (mm Hg).
pap (păp) [L. pappa, infant’s sound for
food] Any soft, semiliquid food.
papain (pă-pā⬘ı̆n) Proteolytic enzyme obtained from the fruit of the papaya, Carica papaya; used to tenderize meat.
Papanicolaou test, Pap test (păp⬙-ănē⬘kă-low⬙) [George Nicholas Papanicolaou, Gr.-born U.S. scientist, 1883–
1962] ABBR: Pap test. A cytological
study used to detect cancer in cells that
an organ has shed. The Pap test has
been used most often in the diagnosis
and prevention of cervical cancers, but
it also is valuable in the detection of
pleural or peritoneal malignancies and
in the evaluation of cellular changes
caused by radiation, infection, or atrophy. SYN: Pap smear.
Cellular material is collected and
smeared on a glass slide. DNA hybrid
testing for HPV can be done on the liquid-based specimen. When suspicious
cells are identified, further testing may
be performed on the same sample. Testing for human papilloma virus (HPV) is
often performed if results show abnormal changes of uncertain significance.
HPV is the primary risk factor for cervical cancer. Currently the two available technologies are Thin Prep Pap
Test and Sure Path. SEE: illus.
TOOLS FOR PAP TEST
(top to bottom) Cytobrush, cervical
cytobroom, and wooden paddle
Since the introduction of the Pap test,
death from cervical cancer in the US has
declined by 70%. Although interpretation of the test is subject to human error, a variety of developments have improved test accuracy, including use of
computer-generated procedures for detection and examination of abnormal
cells and mandated reexamination of
sample batches to test quality control. A
woman may augment the accuracy and
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value of the Pap test by following these
guidelines: Asking her health care provider about the quality of the laboratory
evaluating the results; having an annual Pap test beginning by age 21 or
when the woman becomes sexually active; scheduling the test during a time
when she does not expect to be bleeding;
abstaining from sexual intercourse and
and putting nothing in her vagina; providing a detailed medical history, including use of birth control pills or other
exogenous hormones and results of past
Pap tests; and requesting a second opinion on the Pap test if she is at risk for
cancer of the reproductive tract.
As with any test, it is possible that
human errors may influence results. It is important that the quality of
performance of the technicians and physicians be periodically reviewed by persons not employed by the laboratory or
hospital.
SCREENING
RECOMMENDATIONS:
The American Cancer Society (ACS)
and the American College of Obstetricians and Gynecologists (ACOG) both
recommend that screening for cervical
cancer begin about 3 years after a
woman begins having vaginal intercourse, but no later than age 21. Annual
Pap testing should continue until age
30. After age 30, the ACS says women
can reduce test frequency to every 2 to
3 years if their health care provider uses
the newer liquid-based Pap tests, which
include human papillomavirus (HPV)
typing. In young, sexually active
women, certain types of HPV cause precancerous changes that can lead to cervical cancer. Women who have had a
hysterectomy for benign conditions and
who do not have a cervix no longer need
to undergo screening.
Screening can stop at age 65 or 70 for
those women who have never had positive findings on previous examinations,
as long as they have no new risk factors
for cervical cancer.
Certain women are at high risk for
cervical cancer and may need more frequent testing than the general population. These include women with HPV,
chlamydial, or HIV infection and those
who are immunosuppressed as a result
of other illnesses. Additional risk factors for cervical cancer include early age
at first intercourse, a history of sexually
transmitted illnesses, cigarette smoking or substance abuse, a previous history of cervical dysplasia, a history of
multiple sexual partners, or having a
sexual partner who has other partners
with cervical cancer.
PATIENT CARE: Because Pap testing
papilla
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has been effective in detecting the early
stages of cervical cancer, health care
professionals should advocate this procedure for their female patients and
participate in health promotion efforts
to increase the number of women who
have the test done regularly.
papaya
(pă-pă⬘yă)
[Sp. Amerind.]
1. Carica papaya, a large herb of the
family Caricaceae, native to the American tropics and cultivated for its edible
fruit and latex-bearing leaves and stem,
which contain digestive enzymes.
2. Large, oblong, edible fruit of the Carica papaya plant; the source of the digestive enzyme papain.
paper (pā-pĕr) [L. papyrus, paper]
1. Cellulose pulp prepared in thin
sheets from fibers of wood, rags, and
other substances. 2. Charta. 3. A thin
sheet of cellulosic material impregnated
with specific chemicals that react in a
definite manner when exposed to certain solutions. This permits use of these
papers for testing purposes.
articulating p. Paper coated on one
or both sides with a pigment that marks
the teeth when their occlusal surfaces
contact the paper. This allows the contact points of the teeth to be demonstrated.
bibulous p. Paper that absorbs water
readily.
filter p. A porous, unglazed paper
used for filtration.
indicator p. Paper saturated with a
solution of known strength and then
dried; used for testing the pH (or other
properties) of a solution.
litmus p. SEE: litmus paper.
test p. Paper impregnated with a
substance that will change color when
exposed to solutions of a certain pH or
to specific chemicals.
papilla (pă-pı̆l⬘ă) pl. papillae [L.] A
small, nipple-like protuberance or elevation.
Bergmeister’s p. SEE: Bergmeister’s
papilla.
circumvallate p. One of the large papillae near the base on the dorsal aspect
of the tongue, arranged in a V-shape.
The taste buds are located in the epithelium of the trench surrounding the
papilla. SYN: vallate papilla.
conical p. 1. Papillae on the dorsum
of the tongue. 2. Papillae in the ridgelike projections of the dermis. SYN: papilla of corium.
p. of corium Conical p. (2).
dental p. A mass of connective tissue
that becomes enclosed by the developing
enamel organ. It gives rise to dentin and
dental pulp.
dermal p. Small elevations of the corium that indent the inner surface of the
epidermis.
duodenal p. Papilla of Vater.
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filiform p. One of the very slender papillae at the tip of the tongue.
foliate p. Folds, which are rudimentary papillae, in the sides of the tongue.
fungiform p. One of the broad flat papillae resembling a mushroom, chiefly
found on the dorsal central area of the
tongue.
gingival p. The gingiva that fills the
space between adjacent teeth.
gustatory p. Taste papilla of tongue;
one of those possessing a taste bud.
SYN: taste papilla.
p. of hair A conical process of the corium that projects into the undersurface
of a hair bulb. It contains capillaries
that nourish the hair root. SYN: papilla
pili.
incisive p. A small bump in the mucosa above and just to the front of the
incisive foramen at the very front of the
hard palate. The papilla is used as an
injection site when anesthetizing the
nasopalatine nerve.
interdental p. The triangular part of
the gingivae that fills the area between
adjacent teeth. The papilla includes free
gingiva and attached gingiva and projections seen from the lingual, buccal, or
labial sides of the tooth. SYN: interproximal papilla.
interproximal p. Interdental p.
lingual p. Any one of the tiny eminences covering the anterior two thirds of
the tongue, including circumvallate, filiform, fungiform, and conical papillae.
optic p. Blind spot (1).
parotid p. The projections around
the opening of the parotid duct into the
oral cavity.
p. pili Papilla of hair.
renal p. The apex of a renal pyramid
in the kidney, enclosed by a calyx of the
renal pelvis.
tactile p. A dermal papilla that contains a sensory receptor for touch.
taste p. Gustatory p.
urethral p. The small projection in
the vestibule of the female perineum at
the entrance of the urethra.
vallate p. Circumvallate papilla.
p. of Vater The duodenal end of the
drainage systems of the pancreatic and
common bile ducts; commonly, but inaccurately, called the ampulla of Vater.
SYN: duodenal papilla; hepatopancreatic ampulla.
papillary (păp⬘ı̆-lăr-ē) [L. papilla, nipple]
1. Concerning a nipple or papilla. 2. Resembling or composed of papillae.
p. cystadenoma lymphomatosum
Warthin’s tumor.
p. layer The layer of the corium that
adjoins the epidermis. SYN: stratum
papillare.
papillary carcinoma of the thyroid A
well-differentiated thyroid cancer, and
the most common form of thyroid cancer
papilloma
in the U.S. Most thyroid cancers of this
type grow slowly and respond well to
treatment. They are usually identified
as a thyroid nodule and are best diagnosed with fine needle aspiration biopsy. Treatment includes surgical removal of the thyroid gland, followed by
radioactive iodine treatment to destroy
any residual tissue or metastasis. Survival ten years after diagnosis and
treatment exceeds 90%.
papillate (păp⬘ı̆-lāt) [L. papilla, nipple]
Having nipple-like growths on the surface, as a culture in bacteriology.
papillectomy (păp⬙ı̆-lĕk⬘tō-mē) [⬙ ⫹ Gr.
ektome, excision] Excision of any papilla or papillae.
papilledema (păp⬙ı̆l-ĕ-dē⬘mă) [⬙ ⫹ Gr.
oidema, swelling] Swelling of the optic
nerve with dilated veins, blurred optic
disc margins, flame-shaped hemorrhages in the nerve fiber layer adjacent
to the disc, and an enlarged blind spot
on the visual field. It is caused by increased intracranial pressure, often due
to a tumor of the brain pressing on the
optic nerve. Blindness may result very
rapidly unless relieved. SYN: choked
disk.
papilliform (pă-pı̆l⬘ı̆-form) [⬙ ⫹ forma,
shape] Having the characteristics or
appearance of papillae.
papillitis (păp-ı̆-lı̄⬘tı̆s) [⬙ ⫹ Gr. itis, inflammation] Optic disc swelling caused
by local inflammation; usually acute.
papilloadenocystoma (păp⬙ı̆l-ō-ăd⬙ē-nōsı̆s-tō⬘mă) [⬙ ⫹ Gr. aden, gland, ⫹
kystis, a cyst, ⫹ oma, tumor] A tumor
composed of elements of papilloma, adenoma, and cystoma.
papillocarcinoma (păp⬙ı̆l-ō-kăr-sı̆-nō⬘mă)
[⬙ ⫹ Gr. karkinos, crab, ⫹ oma, tumor] 1. A malignant tumor of hypertrophied papillae. 2. Carcinoma with papillary growths.
papilloma (păp-ı̆-lō⬘mă) [⬙ ⫹ Gr. oma,
tumor] 1. A benign epithelial tumor.
2. Epithelial tumor of skin or mucous
membrane consisting of hypertrophied
papillae covered by a layer of epithelium. Included in this group are warts,
condylomas, and polyps. SEE: acanthoma; papillomavirus.
p. durum A hardened papilloma, as
a wart or corn.
fibroepithelial p. A skin tag containing fibrous tissue.
hard p. Papilloma that develops from
squamous epithelium.
Hopmann’s p. [Carl Melchior Hopmann, Ger. physician, 1849– 1925]
Papillomatous overgrowth of the nasal
mucosa.
intracystic p. Papilloma within a cystic adenoma.
intraductal p. A solitary neoplasm of
the breast that occurs in the large, lactiferous ducts. A distinct neoplasm that
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displays a papillary histological pattern.
p. molle Condyloma.
soft p. Papilloma formed from columnar epithelium; applies to any
small, soft growth.
villous p. Papilloma with thin, long
excrescences present in the urinary
bladder, breast, intestinal tract, or choroid plexus of the cerebral ventricles.
papillomatosis (păp⬙ı̆-lō-mă-tō⬘sı̆s) [⬙ ⫹
Gr. oma, tumor, ⫹ osis, condition]
1. Widespread formation of papillomas.
2. The condition of being afflicted with
many papillomas.
papillomavirus Any of a group of viruses
that cause papillomas or warts in humans and animals. They belong to the
papovavirus family or group. SEE: wart,
genital.
human p. (păp-ı̆-lō⬘mă-v⬙rŭs ABBR:
HPV) A papillomavirus that is specific
to humans and is a common viral sexually transmitted disease in the U.S. A
number of HPV types, esp. HPV 16, 18,
31, and 45, have been shown to contribute to squamous cell cancers of the
anogenital region, including cancers of
the anus, cervix, penis, and vulva. Others
(types 6 and 11) are responsible for genital warts. Cervical cancer kills nearly
4,000 women in the U.S. annually.
A vaccine (brand name Gardasil) has
proven 100% effective in preventing the
two strains of HPV responsible for 70%
of cervical cancer and two responsible
for most genital warts. In June 2006,
the FDA approved the vaccine, and the
CDC includes the HPV vaccine in its
recommended vaccination schedule for
girls age 11 or 12.
The vaccine costs approximately
$360.00, for girls and women age 9 to 26.
The organization “Vaccines of Children”
may cover the expense for some girls if
a health care company refuses coverage.
TREATMENT: Imiquimod is used to
treat warts of the genitals or anus. An
alternative drug treatment is podophyllum. Cervical HPV lesions may be removed by loop electrosurgical excision
procedure. Cryotherapy and laser surgery also may be used in treatment.
papillophlebitis (păp⬙ı̆-lō-flĕ-bı̄⬘tı̆s, păpı̆l⬙ō) [⬙ ⫹ ⬙] Nonischemic central retinal vein occlusion, typically but not exclusively occurring in an otherwise
young or healthy patient.
papilloretinitis (păp⬙ı̆-lō-rĕt-ı̆n-ı̄⬘tı̆s) [⬙
⫹ rete, net, ⫹ Gr. itis, inflammation]
Inflammation of the optic nerve and retina. SYN: retinopapillitis.
papovavirus (păp⬙ō-vă-vı̄⬘rŭs) [papilloma, ⫹ polyoma, ⫹ vacuolating
agent ⫹ virus] Any of a group of viruses important in investigating viral
carcinogenesis; including polyoma virus, simian virus 40 (SV 40), and papillomaviruses.
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pappataci fever (păp-ă-tă-chē) Sandfly
fever.
pappose (păp⬘pōs) [L. pappus, down]
Covered with fine, downy hair.
pappus (păp⬘pŭs) [L.] The first growth
of beard hair appearing on the cheeks
and chin as fine, downy hair.
Pap smear, Pap test (păp) Papanicolaou
test.
papular mucinosis (păp⬘yă-lĕr mū-sı̆nō⬘sı̆s) A rare rash of unknown cause,
in which mucin deposits are found in the
dermis, creating a bumpy (papular)
eruption often found on the face or
arms. The condition is often associated
with lesions of the internal organs and
the presence of paraproteins in the
bloodstream.
papule (păp⬘ūl) [L. papula, pimple] A
small bump or pimple, typically larger
than a grain of salt but smaller than a
peppercorn, that rises above the surface
of the neighboring skin. Papules may
appear in numerous skin diseases, including prickly heat, psoriasis, xanthomatosis, eczema, and skin cancers.
Their color may range from pale, to yellow, red, brown, or black. SEE: illus.
papular (ū-lăr), adj.
PAPULES
dry p. Chancre.
moist p. Condyloma latum.
pearly penile p. An asymptomatic
white papule with a pink, white, or
pearly surface on the dorsum of the penis of blacks and uncircumcised men.
No treatment is indicated, just reassurance.
piezogenic pedal p. A soft, painful,
skin-colored papule present on the non–
weight-bearing portion of the heel. It
disappears when weight is taken off the
foot and heel. This papule is caused by
herniation of fat through connective tissue defects.
split p. Fissures at the corners of the
mouth; seen in some cases of secondary
syphilis.
papulo- [L. papula, pimple] Combining
form indicating pimple, papule.
papuloerythematous
(păp⬙ū-lō-ĕr⬙ĕthĕm⬘ă-tŭs) [⬙ ⫹ Gr. erythema, redness] Denoting the occurrence of papules on reddened skin.
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papulopustular (păp⬙ū-lō-pŭs⬘tū-lăr) [⬙
⫹ pustula, blister] Denoting the presence of both pustules and papules.
papulosis (păp-ū-lō⬘sı̆s) [⬙ ⫹ Gr. osis,
condition] The presence of numerous
and generalized papules.
papulosquamous (păp⬙ū-lō-skwā⬘mŭs)
[⬙ ⫹ squamosus, scalelike] Denoting
the presence of both papules and scales.
papulovesicular
(păp⬙ū-lō-vē-sı̆k⬘ū-lăr)
[⬙ ⫹ vesicula, tiny bladder] Denoting
the presence of both papules and vesicles.
papyraceous
(păp-ı̆-rā⬘shŭs)
[L.]
Parchment-like; in obstetrics, denoting
a fetus that is retained in the uterus beyond natural term and appears mummified.
par [L., equal] A pair, esp. a pair of cranial nerves.
para (păr⬘ă) [L. parere, to bring forth, to
bear] A woman who has produced a viable infant (weighing at least 500 g or of
more than 20 weeks’ gestation) regardless of whether the infant is alive at
birth. A multiple birth is considered to
be a single parous experience. SEE:
gravida; multipara.
para- [Gr. para, beyond; L. par, equal,
pair] Prefix meaning near, beside, past,
beyond, opposite, abnormal, irregular,
two like parts.
-para Suffix meaning to bear forth (offspring).
para-aminohippuric acid (păr⬙ă-ăm⬙ı̆-nōhı̄-pŭr-ı̆k) ABBR: PAHA. A derivative
of aminobenzoic acid. The salt, paraaminohippurate, is used to test the excretory capacity of the renal tubules.
para-aortic body (păr⬙ă-ā-or⬘tı̆k) One of
the small masses of chromaffin tissue
along the abdominal aorta that secrete
epinephrine.
parabiosis (păr⬙ă-bı̄-ō⬘sı̆s) [⬙ ⫹ biosis,
living] 1. The joining together of two individuals. It may occur congenitally as
with conjoined twins or may be produced surgically for experimentation in
animals. parabiotic (−ŏt⬘ı̆k), adj.
parablepsia, parablepsis (păr⬙ă-blĕp⬘sēă, −sı̆s) [Gr. para, beside, ⫹ blepsis, vision] Abnormality of vision (e.g., visual
hallucinations).
paracanthoma (păr⬙ă-kăn-thō⬘mă) [Gr.
para, beside, ⫹ akantha, thorn, ⫹
oma, tumor] A tumor involving the
prickle-cell layer of the epidermis.
paracasein (păr-ă-kā⬘sē-ı̆n) An insoluble
protein formed when rennin or pepsin
acts on the casein in milk; this reaction,
which results in the curdling of milk, occurs only in the presence of calcium
ions.
paracellular (păr⬙ă-sĕl⬘ū-lı̆r) [⬙ ⫹ ⬙]
Pertaining to pathways or junctions between or around cells. It is used for ions
that pass through an epithelial membrane without entering its cells.
paracrine
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paracentesis
(păr⬙ă-sĕn-tē⬘sı̆s)
[Gr.
para, beside, ⫹ kentesis, a puncture]
The puncture of a cavity with removal
of fluid, as in pleural effusion or ascites.
In common parlance, “paracentesis” refers to aspiration of fluid from within
the peritoneum. paracentetic (−tĕt⬘ı̆k),
adj.
PATIENT CARE: The procedure is explained to the patient and an informed
consent is obtained. The patient is assessed for allergies, including local anesthetics and antiseptic agents, and for
bleeding and coagulation abnormalities.
The patient should have an intravenous
access and should empty his/her bladder before the procedure. Emotional
support is offered during the procedure,
and the patient is encouraged to express
feelings. The patient is positioned as directed by the physician. Vital signs are
monitored, especially for changes in respiratory rate, pulse, and blood pressure.
The amount of fluid removed is measured and recorded, and its appearance,
color, consistency, odor, and specific
gravity are noted. The puncture site is
observed, a pressure dressing applied,
and redressed as necessary. Specimens
are sent to laboratories as directed. The
procedure and the patient’s response
are documented, and the patient is monitored for several hours after the procedure, e.g., for bleeding or drainage from
the puncture site, or worsening internal
pain.
paracentral lobule SEE: under lobule.
paracephalus (păr⬙ă-sĕf⬘ă-lŭs) [⬙ ⫹
kephale, head] A parasitic placental
twin with a small rudimentary head.
paracholera (păr⬙ă-kŏl⬘ĕr-ă) [⬙ ⫹ L.
cholera, cholera] A disease resembling
cholera but caused by vibriones other
than true Vibrio cholerae.
Paracoccidioides
(păr⬙ă-kŏk-sı̆d⬙ēoy⬘dēz) A genus of yeastlike fungi.
P. brasiliensis The species that
causes South American blastomycosis.
SYN: Blastomyces brasiliensis.
paracoccidioidomycosis
(păr⬙ă-kŏksı̆d⬙ē-ŏy⬙dō-mı̄-kō⬘sı̆s) A chronic granulomatous disease of the skin caused by
Paracoccidioides brasiliensis. SYN:
South American blastomycosis.
paracolitis (păr⬙ă-kō-lı̄⬘tı̆s) Inflammation of the tissue surrounding the colon.
paracolpitis (păr⬙ă-kŏl-pı̄⬘tı̆s) [⬙ ⫹ kolpos, vagina, ⫹ itis, inflammation] Inflammation of tissues surrounding the
vagina.
paracone (păr⬘ă-kōn) [⬙ ⫹ konos, cone]
The mesiobuccal cusp of an upper molar
tooth.
paraconid (păr⬙ă-kō⬘nı̆d) The mesiobuccal cusp of a lower molar tooth.
paracrine (păr⬙ă-krēn) Secretion of a
hormone from a source other than an
endocrine gland.
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Groups of chromaffin cells, similar in
staining reaction to cells of the adrenal
medulla, associated anatomically and
embryologically with the sympathetic
system. They are located in various organs and parts of the body.
paraganglioma (păr⬙ă-găng-lē-ō⬘mă) [⬙
⫹ ⬙ ⫹ oma, tumor] An extra-adrenal
tumor composed of neural crest cells,
which may release catecholamines into
the systemic circulation and cause
symptoms of sustained or episodic hypertension, with sweating, palpitations,
and headache. Paragangliomas usually
are found in the paravertebral ganglia
or the carotid bodies.
paraganglion (păr⬙ă-găng⬘lē-ŏn) [⬙ ⫹
ganglion, knot] Sing. of paraganglia.
parageusia, parageusis (păr-ă-gū⬘sē-ă,
−sı̆s) [⬙ ⫹ geusis, taste] Disorder or
abnormality of the sense of taste. Intravenous fluid therapy, esp. postoperatively, may create temporary parageusia and parosmia.
paragnathus (păr-ăg⬘nă-thŭs) [⬙ ⫹
gnathos, jaw] 1. A congenital deformity
in which there is an accessory jaw. 2. A
parasitic fetus attached to the outer
part of the jaw of the autosite.
paragonimiasis
(păr⬙ă-gŏn⬙ı̆-mı̄⬘ă-sı̆s)
[Paragonimus ⫹ −iasis, condition] Infection with worms of the genus Paragonimus. The clinical signs depend on
the path the worm takes in migrating
through the body, after the larvae contained in partially cooked freshwater
crabs or crayfish are eaten. The larvae
migrate from the duodenum to various
organs, including the lungs, intestinal
wall, lymph nodes, brain, subcutaneous
tissues, and genitourinary tract. When
the lungs are involved, the symptoms
are cough and hemoptysis. In peritoneal
infections, there may be an abdominal
mass, pain, and dysentery. When the
larvae invade the brain, paralysis, epilepsy, homonymous hemianopsia, optic
atrophy, and papilledema are common.
In some cases, the infected person may
appear to be well. This infection is
treated by administration of praziquantel.
Paragonimus (păr⬙ă-gŏn⬘ı̆-mŭs) A genus
of trematode worms.
P. westermani The lung fluke, a
common parasite of certain mammals
including humans, dogs, cats, pigs, and
minks. Human infestation occurs
through eating partially cooked crabs or
crayfish, the second intermediate host.
This infestation is endemic in certain
parts of Asia. SEE: illus.
paragrammatism (pă-ră-grăm⬘ă-tı̆z-ı̆m)
A speech defect characterized by improper use of words and inability to arrange them grammatically.
paragranuloma
(păr⬙ă-grăn⬙ū-lō⬘mă)
[Gr. para, beside, ⫹ L. granulum, lit-
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p. control A general form of bioregulation in which one cell type in a tissue selectively influences the activity of
an adjacent cell type by secreting chemicals that diffuse into the tissue and act
specifically on cells in that area. SEE:
factor, autocrine.
paracusia, paracusis (păr⬙ă-kū⬘sē-ă, −kŭ⬘
sı̆s) [⬙ ⫹ akousis, hearing] Any abnormality or disorder of the sense of
hearing.
p. loci Difficulty in locating the direction of sound.
paracystitis (păr⬙ă-sı̆s-tı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
itis, inflammation] Inflammation of
connective tissues and other structures
around the urinary bladder.
paracytic (păr⬙ă-sı̆t⬘ı̆k) [⬙ ⫹ kytos, cell]
Concerning cells other than those normally present in a specific location.
paradenitis (păr⬙ăd-ĕn-ı̄⬘tı̆s) [⬙ ⫹ aden,
gland, ⫹ itis, inflammation] Inflammation of tissues around a gland.
paradental (păr⬙ă-dĕn⬘tăl) [⬙ ⫹ L. dens,
tooth] 1. Concerning the practice of
dentistry. 2. Periodontal.
paradidymis (păr-ă-dı̆d⬘ı̆-mı̆s) [⬙ ⫹ didymos, testicle] The atrophic remnants
of the tubules of the wolffian body, situated on the spermatic cord above the
epididymis.
paradigm (pă⬘rădı̄m) 1. An example
that serves as a model. 2. Conceptual
model.
paradox (pă-rădŏks) [Gr. paradoxos,
conflicting with expectation] A condition or statement that on superficial examination seems contradictory or illogical.
Weber’s p. Paradox that states that
a muscle loaded beyond its ability to
contract may elongate.
paraffin (păr⬘ă-fı̆n) [L. parum, too little,
⫹ affinis, neighboring] 1. A waxy,
white, tasteless, odorless mixture of
solid hydrocarbons obtained from petroleum; used as an ointment base or
wound dressing. SEE: petrolatum.
2. One of a series of saturated aliphatic
hydrocarbons having the formula
CnH2n⫹2. Paraffins constitute the methane or paraffin series. 3. A series of solid
waxes prepared according to their melting point, to be used to infiltrate and
embed tissues for sectioning in the preparation of microscope slides.
paraformaldehyde
(păr⬙ă-for-măl⬘dĕhı̄d) A white, powdered antiseptic and
disinfectant, a polymer of formaldehyde.
paragammacism
(păr⬙ă-găm⬘mă-sı̆zm)
[Gr. para, beside, ⫹ gamma, Gr. letter
G, ⫹ −ismos, condition] An inability to
pronounce “g,” “k,” and “ch” sounds,
with substitution of other consonants
such as “d” or “t.”
paraganglia (păr⬙ă-găng⬘lē-ă) sing., paraganglion [⬙ ⫹ ganglion, knot]
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paragraphia
1703
paralysis
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paralgia (păr-ăl⬘jē-ă) [⬙ ⫹ algos, pain]
An abnormal sensation that is painful.
(păr⬘ă-lăks) [Gr. parallaxis,
change of position] The apparent movement or displacement of objects caused
by change in the observer’s position or
by movement of the head or eyes.
binocular p. The basis of stereoscopic
vision; the difference in the angles
formed by the lines of sight to two objects at different distances from the
eyes. This is important in depth perception.
heteronymous p. Parallax in which,
when one eye is closed, the object
viewed appears to move closer to the
closed eye.
homonymous p. Parallax in which,
when one eye is covered, the object
viewed appears to move closer to the uncovered eye.
parallelometer (păr⬙ă-lĕl-ŏm⬘ĕ-tĕr) A device used in dentistry to determine
whether lines and tooth surfaces are
parallel to each other.
parallel play (pă-ră-lĕl) The stage in social development in which a child plays
alongside, but not with, other children;
characteristic of toddlers.
parallel trial A research study in which
groups of patients are followed for the
same time but are given different treatments; e.g., one group may receive an
inactive substance while another is
treated with a drug whose effectiveness
must be determined. The impact of the
drug can thus be compared with the placebo at varying times, such as 4 weeks,
4 months, or 4 years after the study begins.
paralogia (păr⬙ă-lō⬘jē-ă) [Gr. para, beside, ⫹ logos, word, reason] A disorder of reasoning.
benign p. Disordered thinking and
communication of thought in which delusions, bizarre thoughts, hallucinations, and regressive behavior are absent. Affected patients are not severely
incapacitated.
paralogism (păr⬙ă-lō⬘jı̆z-ĕm) An incorrectly chosen word inserted into speech,
esp. in patients with fluent aphasias.
SEE: neologism; paraphasia.
paralysis (pă-răl⬘ı̆-sı̆s) pl. paralyses [Gr.
paralyein, to disable] 1. Loss of sensation; anesthesia. 2. Loss of purposeful
movement, usually as a result of neurological disease (e.g., strokes, spinal
cord injuries, poliomyelitis), drugs, or
toxins. Loss of motor function may be
complete (paralysis) or partial (paresis),
unilateral (hemiplegic) or bilateral (diplegic), confined to the lower extremities (paraplegic) or present in all four
extremities (quadraplegic), accompanied by increased muscular tension and
hyperactive reflexes (spastic) or by loss
of reflexes and tone (flaccid). SYN:
palsy.
parallax
PARAGONIMUS WESTERMANI (⫻4)
tle grain, ⫹ Gr. oma, tumor] A benign
form of Hodgkin’s disease usually limited to lymph nodes.
paragraphia
(păr-ă-grăf⬘ē-ă)
[⬙
⫹
graphein, to write] The writing of letters or words other than those intended.
parahemophilia (pă⬙ră-hēm⬙ō-fēl⬘ē-ă) A
rare, autosomal recessive bleeding disorder in which there is a deficiency in
blood clotting factor V. SYN: Owren’s
disease.
parahypnosis (pă-ră-hı̆p-nō-sı̆s) [⬙ ⫹
hypnos, sleep] Abnormal or disordered
sleep.
parainfluenza viruses
(pă-ră-ı̆n-flooĕn⬘ză) A group of viruses that cause
acute respiratory infections in humans,
esp. in children. Virtually all children in
the U.S. have been infected by age 6.
parakeratosis (păr⬙ă-kĕr⬙ă-tō⬘sı̆s) [⬙ ⫹
keras, horn, ⫹ osis, condition] The
persistence of nuclei within the keratinocytes of the stratum corneum of epidermis or mucosal layers, which indicates a partial keratinization process; a
general term applied to disorders of the
keratinized layer of the skin.
p. ostracea Parakeratosis scutularis.
p. psoriasiformis Scab formation resembling that of psoriasis.
p. scutularis A scalp disease with
hairs encircled by epidermic crust formation. SYN: p. ostracea.
parakinesia, parakinesis (păr⬙ă-kı̆-nē⬘zēă, −sı̆s) [⬙ ⫹ kinesis, movement] A
condition in which movement is abnormal.
paralalia (păr⬙ă-lā⬘lē-ă) [⬙ ⫹ lalein, to
babble] Any speech defect characterized by sound distortion.
p. literalis Stammering.
paralambdacism (păr⬙ă-lăm⬘dă-sı̆zm) [⬙
⫹ lambda, Gr. letter L, ⫹ ⬙] Inability
to say the letter “l” correctly, with the
substitution of the sound of another letter for it.
paralepsy (păr⬘ă-lĕp⬙sē) [⬙ ⫹ lepsis, seizure] A temporary attack of mental inertia and hopelessness, or sudden alteration in mood or mental tension.
paralexia (păr⬙ă-lĕk⬘sē-ă) [⬙ ⫹ lexis,
speech] An inability to comprehend
printed words or sentences, together
with substitution of meaningless combinations of words.
short
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paralysis
1704
PATIENT CARE: Referral is made to
the rehabilitation therapists for evaluation of the patient’s motor and sensory
capabilities (muscle size, tone and
strength, reflex or involuntary movement, response to touch or to painful
stimuli). The patient is positioned to
prevent deformities. Passive range of
motion is performed on the involved extremities to prevent contractures. The
patient is repositioned frequently to
prevent pressure sores. Local and systemic responses, including fatigue, are
evaluated. The rehabilitation team assesses and attends to any self-care deficits the patient may have. Support is
offered to the patient and family to assist them in dealing with psychological
concerns and the response to grief and
loss. Assistance is provided to help the
patient in achieving an optimal level of
function and in adapting to the disability.
Important concerns include functional positioning, the prevention of deformities secondary to spasticity, and
the prevention of injury when sensation
is absent. A plan may be prescribed for
muscle re-education and compensatory
training. Functional orthoses and assistive technology devices may be necessary to assist the patient in performing
self-care and other tasks of daily living.
p. of accommodation Inability of
the ciliary muscles to alter the lens to
focus on near or far objects.
acoustic p. Deafness.
p. agitans Parkinson’s disease.
alcoholic p. Paralysis caused by the
toxic effect of alcohol on spinal nerves.
SYN: alcoholic paraplegia.
Bell’s p. Bell’s palsy.
birth p. Loss of function due to nerve
injury during delivery. Trauma to the
baby during delivery may result in damage to the brachial nerves, facial nerves,
or diaphragm. Asymmetrical movements or reflexes of the affected part are
present. Prognosis depends on the
amount of nerve damage sustained; permanent damage is rare. Most newborn
paralyses resolve without sequelae
within a few weeks or a few months after birth. SYN: birth palsy; brachial
palsy; obstetrical paralysis.
brachial p. Paralysis arising from an
injury received at birth to the brachial
nerve.
brachiofacial p. Paralysis of the face
and an arm.
bulbar p. Paralysis caused by
changes in the motor centers of the medulla oblongata. SYN: progressive bulbar paralysis.
complete p. Paralysis in which there
is total loss of function and sensation.
conjugate p. Paralysis of the conjugate movement of the eyes in all direc-
paralysis
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tions even though the fixation axis remains parallel.
crossed p. Paralysis affecting muscles of one side of the face and those in
the limbs on the opposite side of the
body.
crutch p. Paralysis due to pressure
on nerves in the axilla caused by improper use of a crutch.
decubitus p. Paralysis caused by
compression of a nerve after lying on it
(e.g., in sleep or a coma).
diphtheritic p. Paralysis of the muscles of the palate, eyes, limbs, diaphragm, and intercostal muscles as a
complication of diphtheria. It is caused
by a bacterial toxin. SYN: postdiphtheritic paralysis.
diver’s p. Decompression illness.
Duchenne-Erb p. SEE: DuchenneErb paralysis.
facial p. Paralysis of the facial or the
trigeminal nerve; Bell’s palsy.
flaccid p. Paralysis in which there is
loss of muscle tone, loss or reduction of
tendon reflexes, and atrophy and degeneration of muscles. It is caused by lesions of the lower motor neurons of the
spinal cord.
general p. Paresis.
ginger p. Jamaica ginger p.
glossolabial p. Paralysis of the
tongue and lips occurring in bulbar paralysis.
Gubler’s p. SEE: Gubler’s paralysis.
hyperkalemic p. A rare form of periodic paralysis characterized by brief
(1- to 2-hr) attacks of limb weakness.
Respiratory muscles are involved in
some cases. “Hyperkalemic” is misleading because the potassium levels may be
normal. But, because an attack is precipitated by the administration of potassium, this form of paralysis is better
termed “potassium-sensitive periodic
paralysis.”
TREATMENT: Emergency treatment
is seldom necessary. Oral glucose hastens recovery. Attacks may be prevented by acetazolamide or thiazide diuretics.
hypokalemic periodic p. A form of
periodic paralysis with onset usually before adulthood. An attack typically
comes on during sleep, after strenuous
exercise during the day. The weakness
may be so pronounced as to prevent the
patient from being able to call for help.
The attack may last from several hours
to a day or more. The diagnosis is established by determining that the serum
potassium level is decreased during an
attack.
TREATMENT: Administration of oral
potassium salts improves the paralysis.
If the patient is too weak to swallow, intravenous potassium salts are required.
Attacks may be prevented by oral ad-
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paralysis
1705
ministration of 5 to 10 g of potassium
chloride daily.
immunological p. The inability to
form antibodies after exposure to large
doses of an antigen.
incomplete p. Partial paralysis of
the body or a part.
infantile p. Poliomyelitis.
infantile cerebral ataxic p. Cerebral
palsy.
ischemic p. Volkmann’s contracture.
Jamaica ginger p. Paralysis due to
polyneuropathy that affects the muscles
of the distal portions of the limbs. It is
caused by drinking Jamaica ginger, an
alcoholic beverage containing the toxin
triorthocresylphosphate.
Klumpke’s p. SEE: Klumpke’s paralysis.
Landry’s p. Flaccid paralysis that begins in the lower extremities and rapidly ascends to the trunk.
laryngeal p. Loss of vocal fold mobility. Common causes include surgical
trauma to the recurrent laryngeal nerve
or invasion of the nerve by a tumor.
SYN: vocal paralysis.
lead p. Paralysis due to lead poisoning.
leaden p. Extreme fatigue, a symptom of atypical depression.
local p. Paralysis of a single muscle
or one group of muscles.
mimetic p. Paralysis of the facial
muscles.
mixed p. Paralysis of the motor and
sensory nerves.
muscular p. Loss of the capacity of
muscles to contract. It may be due to a
structural or functional disorder in the
muscle at the myoneural junction, in efferent nerve fibers, in cell bodies of nuclei of origin of the brain or of the gray
matter of the spinal cord, in conducting
pathways of the brain or spinal cord, or
in motor centers of the brain.
musculospiral p. Saturday night
palsy.
nuclear p. Paralysis caused by lesion
of nuclei in the central nervous system.
obstetrical p. Birth p.
ocular p. Paralysis of the extraocular
and intraocular muscles.
postdiphtheritic p. Diphtheritic p.
posticus p. Paralysis of the posterior
cricothyroid muscles.
Pott’s p. SYN: Pott’s paraplegia.
SEE: under Pott, John Percivall.
primary periodic p. The occurrence
of intermittent weakness, usually following rest or sleep and almost never
during vigorous activity. The condition
usually begins in early life and rarely
has its onset after age 25. The attacks
may last from a few hours to a day or
more. The patient is alert during an attack.
The causes include hypokalemia, hy-
paralytic ileus
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perkalemia, thyrotoxicosis, and a form
of paramyotonia. Both forms of the disease in which potassium regulation is a
factor respond to acetazolamide. The
thyrotoxicosis-related
disorder
is
treated by correcting the underlying
thyrotoxicosis. Spironolactone is the
treatment for cases of paramyotonia
congenita with periodic paralysis.
progressive bulbar p. Bulbar p.
pseudobulbar p. Paralysis caused by
cerebral center lesions, simulating the
bulbar types of paralysis.
pseudohypertrophic muscular p.
SEE: dystrophy, pseudohypertrophic
muscular.
radial p. Saturday night palsy.
Saturday night p. Saturday night
palsy.
sensory p. Loss of sensation due to a
structural or functional disorder of the
sensory end organs, sensory nerves,
conducting pathways of the spinal cord
or brain, or the sensory centers in the
brain.
sleep p. Brief, temporary inability to
move or speak when falling asleep or
awakening.
spastic p. Paralysis usually involving groups of muscles. It is caused by an
upper motor neuron lesion and is characterized by excessive tone and spasticity of muscles, exaggeration of tendon
reflexes but loss of superficial reflexes,
and positive Babinski’s reflex.
Sunday morning p. Saturday night
palsy.
supranuclear p. Paralysis resulting
from disorders in pathways or centers
above the nuclei of origin.
tick-bite p. Paralysis resulting from
bites of some species of ticks whose saliva contains a toxin, esp. of the genera
Ixodes and Dermacentor. It affects
domestic animals and humans, esp.
children, and causes a progressive ascending, flaccid motor paralysis. Recovery usually occurs after removal of the
ticks.
tourniquet p. Paralysis, esp. of the
arm, resulting from a tourniquet being
applied for too long a time.
vasomotor p. Paralysis of the vasomotor centers, resulting in lack of tone
and dilation of the blood vessels.
vocal p. Laryngeal p.
Volkmann’s p. Volkmann’s contracture.
wasting p. Spinal muscular atrophy.
paralytic (păr⬙ă-lı̆t⬘ı̆k) [Gr. paralyein, to
disable]
1. Concerning
paralysis.
2. One afflicted with paralysis.
paralytic ileus Paralysis of the intestinal
smooth muscles with distention of the
abdomen, nausea or vomiting, abdominal pain, and inability to pass stool or
gas. It may occur after abdominal surgery, during an episode of peritonitis, or
short
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paralyzant
paramyotonia
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tics based on the assumption that the
samples measured are from normally
distributed populations.
parametritic (păr⬙ă-mĕ-trı̄t⬘ı̆k) Concerning parametritis.
parametritis (păr⬙ă-mĕ-trı̄⬘tı̆s) [⬙ ⫹ metra, uterus, ⫹ itis, inflammation] An
inflammation of the parametrium, the
cellular tissue adjacent to the uterus. It
may occur in puerperal fever or septic
conditions of the uterus and appendages. SYN: pelvic cellulitis.
parametrium (păr-ă-mē⬘trē-ŭm) [⬙ ⫹
metra, uterus] Loose connective tissue
around the uterus.
paramimia (păr⬙ă-mı̆m⬘ē-ă) [⬙ ⫹ mimeisthai, to imitate] The use of gestures
that are inappropriate to the spoken
words that they accompany.
paramnesia (păr⬙ăm-nē⬘zē-ă) [⬙ ⫹ amnesia, loss of memory] 1. Use of words
without meaning. 2. Distortion of memory in which there is inability to distinguish imaginary or suggested experiences from those that have actually
occurred. 3. Seeming recall of events
that never have occurred.
paramolar (păr⬙ă-mō⬘lăr) A supernumerary tooth close to a molar.
paramucin (păr⬙ă-mū⬘sı̆n) A glycoprotein found in ovarian and some other
cysts.
paramusia
(păr⬙ă-mū⬘zē-ă)
[⬙
⫹
mousa, music] A form of aphasia in
which the ability to render music correctly is lost.
paramyloidosis (păr-ăm⬙ı̆-loy-dō⬘sı̆s) [⬙
⫹ L. amylum, starch, ⫹ Gr. eidos,
form, shape, ⫹ osis, condition] The
presence and buildup of atypical amyloid in tissues.
paramyoclonus multiplex (păr-ă-mı̄ŏk⬘lō-nŭs mŭl⬘tı̆-plĕks) [⬙ ⫹ mys,
muscle, ⫹ klonos, tumult] Sudden
and frequent shocklike contractions
usually affecting the muscles of both
legs, and particularly the trunk muscles. The contractions, which disappear
during sleep and motion, may occur 10
to 50 times each minute. Usually the
condition develops spontaneously, but it
has been known to follow fright,
trauma, infectious diseases, and poliomyelitis. SYN: polymyoclonus.
paramyosinogen (păr⬙ă-mı̄⬙ō-sı̆n⬘ō-jĕn)
[Gr. para, beside, ⫹ myosin, protein
globin of muscle, ⫹ gennan, to produce] Protein derived from muscle tissue.
paramyotonia (păr⬙ă-mı̄⬙ō-tō⬘nē-ă) [⬙ ⫹
mys, muscle, ⫹ tonos, tone] A disorder marked by muscular spasms and
abnormal muscular tonicity.
ataxic p. Tonic muscular spasm with
slight ataxia or paresis during any attempt at movement.
p. congenita A congenital condition
of tonic muscular spasms when the body
short
standard
1706
after the administration of some drugs
(e.g., narcotics).
paralyzant (păr⬘ă-lı̄z⬙ănt) [Fr. paralyser,
paralyze] 1. Causing paralysis. 2. A
drug or other agent that induces paralysis.
paralyze (păr⬘ă-lı̄z) [Fr. paralyse] 1. To
cause temporary or permanent loss of
muscular power or sensation. 2. To render ineffective.
paralyzer (păr⬘ă-lı̄z⬙ĕr) 1. That which
causes paralysis. 2. A substance that inhibits a chemical reaction.
paramagnetic (păr⬙ă-măg-nĕt⬘ı̆k) Anything that is attracted by the poles of a
magnet and becomes parallel to the
lines of magnetic force.
paramania (păr⬙ă-mā⬘nē-ă) [Gr. para,
beside, ⫹ mania, madness] A type of
emotional disturbance in which the individual derives pleasure from complaining.
paramastigote (păr⬙ă-măs⬘tı̆-gōt) [⬙ ⫹
mastix, lash] Having a small supernumerary flagellum next to a larger one.
paramastitis (păr⬙ă-măs-tı̄⬘tı̆s) [⬙ ⫹
mastos, breast, ⫹ itis, inflammation]
Inflammation around the breast.
paramedian (păr⬙ă-mē⬘dē-ăn) [⬙ ⫹ L.
medianus, median] Close to the midline. SYN: paramesial.
paramedian incision A surgical incision,
esp. of the abdominal wall, close to the
midline.
paramedic (păr⬙ă-mĕd⬘ı̆k) [Gr. para, beside, ⫹ L. medicus, doctor] A health
care professional trained in the emergency care of patients who suffer from
acute illnesses or injuries. Paramedics
typically function in the out-of-hospital
setting, under the medical direction of a
physician. They are trained to provide
assessment and management including
cardioversion, defibrillation, electrocardiographic interpretation, external pacing, IV therapy, thoracic decompression, endotracheal intubation, and drug
and fluid therapy. SEE: emergency medical technician.
paramedical (pă-ră-mĕd-ı̆-lăl) Supplementing the work of medical personnel.
paramedical personnel Health care
workers who are not physicians or
nurses. These include medical technicians, emergency medical technicians,
and physician assistants. SEE: allied
health professional.
paramesial (păr⬙ă-mē⬘sē-ăl) [⬙ ⫹ mesos, middle] Paramedian.
parameter (pă-răm⬘ĕ-tĕr) [⬙ ⫹ metron,
measure] 1. In mathematics, an arbitrary constant, each value of which determines the specific form of the equation in which it appears. The term is
often misused for variable. 2. In biostatistics, a measurable or adjustable characteristic; a named value. parametric
(păr⬙ă-mĕ⬘trı̆k), adj.
parametric statistics The class of statis-
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
paramyotonia
1707
is exposed to cold. SYN: Eulenburg’s disease.
symptomatic p. Temporary muscular rigidity when one first tries to walk,
as in Parkinson’s disease.
paramyxovirus
(pă-ră-mı̆k⬘sō-vı̄-rŭs)
Any virus of a subgroup of the myxoviruses that are similar in physical, chemical, and biological characteristics, even
though they are quite different pathogenetically. The group includes parainfluenza, measles, mumps, Newcastle
disease, and respiratory syncytial viruses.
paraneoplastic syndromes (pă-ră-nēōplăs⬘-tı̆k) Indirect effects of cancers,
such as metabolic disturbances or hormonal excesses produced by chemicals
released by tumor cells. Tumors such as
small-cell carcinoma of the lung, hypernephroma, and neuroendocrine cancers
are often responsible.
paranesthesia (păr⬙ăn-ĕs-thē⬘zē-ă) [⬙ ⫹
an-, not, ⫹ aisthesis, sensation] Anesthesia of the lower body.
paraneuron (păr⬙ă-noor⬘ŏn, −nūr⬘) A cell
of epithelial origin with a membrane
that can generate an action potential
and with the ability to secrete neurotransmitter at a synaptic junction but
without dendrites or axon, e.g., the primary sensory cells in taste buds.
paranoia (păr⬙ă-noy⬘ă) [Gr. para, beside,
⫹ nous, mind] A condition in which
patients show persistent persecutory
delusions or delusional jealousy. The
disorder must last at least 1 week. It
may be accompanied by delusional jealousy or by symptoms of schizophrenia
(e.g., bizarre delusions or incoherence).
There are no prominent hallucinations;
a full depressive or manic syndrome is
either absent or brief. The illness is not
due to organic disease of the brain. SYN:
paranoid disorder; paranoid ideation.
SEE: paranoid reaction type.
This disorder, which usually occurs in
middle or late adult life and may be
chronic, often includes resentment and
anger that may lead to violence. Paranoid people rarely seek medical attention but are brought for care by associates or relatives.
erotomanic type p. Erotomania.
litigious p. Paranoia in which the patient institutes or threatens to institute
legal action because of the imagined
persecution.
somatic p. The delusion that one’s
body is malodorous, infested with an
internal or external parasite, or misshapen or ugly.
paranoiac (păr-ă-noy⬘ăk) 1. Concerning
or afflicted with paranoia. 2. One suffering from paranoia.
paranoid (păr⬘ă-noyd) [⬙ ⫹ nous, mind,
⫹ eidos, form, shape] 1. Resembling
paranoia. 2. A person afflicted with
paranoia.
paraphimosis
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base of rh
paranoid disorder Paranoid personality
disorder (under personality disorder).
SEE: Nursing Diagnoses Appendix.
paranoid ideation Paranoia.
paranoid reaction type An individual
who has fixed systematized delusions, is
suspicious, has a persecution complex,
is resentful and bitter, and is a megalomaniac. Many states approach true
paranoia and resemble it but lack one
or more of its distinguishing features.
Some of these are transitory paranoid
states caused by toxic conditions, a
paranoid type of schizophrenia, and
paranoid states due to alcoholism.
paranomia (păr⬙ă-nō⬘mē-ă) [⬙ ⫹ onoma, name] Inability to remember correct names of objects shortly after seeing or using them.
paranormal (pă-ră-nŏr-măl) 1. Pert. to
experiences that are not explainable scientifically. SEE: extrasensory perception; psychokinesis. 2. Moderately abnormal.
paranuclear (păr⬙ă-nū⬘klē-ăr) Adjacent
to the nucleus of a cell.
paranucleolus (păr⬙ă-nū-klē⬘ō-lŭs) A
darkly staining structure within a cell
nucleus.
paranucleus (păr⬙ă-nū⬘klē-ŭs) [Gr. para,
beside, ⫹ L. nucleus, a kernel] A
structure next to the nucleus of a cell.
paraoperative (păr⬙ă-ŏp⬘ĕr-ă-tı̆v) [⬙ ⫹
L. operari, to work] Perioperative.
paraparesis (păr⬙ă-păr-ē⬘sı̆s, −păr⬘ĕ-sı̆s)
[⬙ ⫹ parienai, to let fall] Partial paralysis affecting the lower limbs.
tropical spastic p. A gradually progressive disease of the spinal cord
caused by infection with human T-cell
lymphotropic virus– I. SYN: HTLV-1–
associated myelopathy.
SYMPTOMS: Symptoms include back
pain with gradual loss of motor function
in one or both legs, ataxia, and urinary
incontinence.
parapeptone (păr⬙ă-pĕp⬘tōn) [⬙ ⫹ peptein, to digest] Intermediate digestion
product of albumin. SEE: peptone.
paraphasia
(păr-ă-fā⬘zē-ă)
[⬙
⫹
aphasis, speech loss] A form of aphasia
in which a meaningless or inappropriate word or syllable is substituted for
the correct spoken word or word combinations. SYN: paraphemia; paraphrasia. paraphasic (−fā⬘zı̆k), adj.
paraphemia
(păr⬙ă-fē⬘mē-ă)
[⬙
⫹
pheme, speech] Paraphasia.
paraphilia (pă-ră-fēl⬘ē-ă) [⬙ ⫹ philein,
to love] A psychosexual disorder in
which unusual or bizarre imagery or
acts are necessary for realization of
sexual excitement. Included in this disorder are bestiality, fetishism, transvestism, zoophilia, pedophilia, exhibitionism, voyeurism, sexual masochism, and
sexual sadism.
paraphimosis (păr⬙ă-fı̄-mō⬘sı̆s) [⬙ ⫹
phimoun, to muzzle, ⫹ osis, condition]
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paraphrasia
1708
Strangulation of the glans penis due to
retraction of a narrowed or inflamed
foreskin.
paraphrasia (păr-ă-frā⬘zē-ă) [Gr. para,
beside, ⫹ phrasis, speech] Paraphasia.
paraplasm (păr⬘ă-plăzm) [Gr. para, beside, ⫹ LL. plasma, form, mold]
1. Any abnormal new formation or malformation. 2. The fluid portion of cytoplasm.
paraplastic (păr⬙ă-plăs⬘tı̆k) [⬙ ⫹ plastikos, formed] 1. Misshapen; deformed.
2. Pert. to the fluid portion of the protoplasm.
paraplegia (păr-ă-plē⬘jē-ă) [Gr. paraplegia, stroke on one side] Paralysis of the
lower portion of the body and of both
legs. It is caused by a lesion involving
the spinal cord that may be due to maldevelopment, epidural abscess, hematomyelia, acute transverse myelitis, spinal neoplasms, multiple sclerosis,
syringomyelia, or trauma. SEE: Nursing Diagnoses Appendix.
PATIENT CARE: Patient care during
the acute period, immediately following
traumatic injury, aims at stabilizing the
patient and preventing further injury or
deterioration. Initial and ongoing neurological assessment by nurses, the neurologist, and the neurosurgeon helps to
determine the level and degree of paralysis and the patient’s potential for recovery. Supportive medical therapy,
based on assessment results, is provided. Specific medical, neurological,
and neurosurgical interventions depend
on the etiology of the paraplegia. Prescribed therapies are administered, and
desired and adverse effects assessed for.
The patient should have early consultations with physical and occupational
therapy staff, because correct body
alignment, positioning, and exercise can
prevent complications, encouraging the
patient to think about rehabilitation
from the beginning. The respiratory
therapist also is involved early on to
monitor ventilatory activity and help
prevent respiratory complications. If intensive care is required, the health care
provider recognizes the need to limit
sensory overload by controlling and
moderating environmental stimuli and
to avoid sleep deprivation by planning
an uninterrupted sleep time. Because
immobility affects all body systems,
they must each be monitored for expected and complicating changes. Medical consultations (e.g., with a pulmonologist, urologist) are made as
necessary, and treatment regimens are
developed based on each patient’s needs.
The patient experiences paraplegia as
a profound loss, affecting not only independent mobility but also self-image
and self-esteem. Although the loss may
be sudden or gradual, predictable or un-
paraplegia
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expected, and temporary or permanent,
depending on the cause of the patient’s
paraplegia, it is present nevertheless.
Because family members also are affected, the health care provider includes
them when helping the patient with
grief work and mourning, recognizing
that anger and despondency are expected responses. Referral to a mental
health care provider can help patients
cope with their loss.
Patients with paraplegia are usually
transferred to a rehabilitation facility
once the acute period has passed. This
move often engenders transfer anxiety,
as the patient and family fear a lesser
level of care as a threat to security and
well-being. Behavioral and psychosomatic manifestations may occur. A liaison nurse from the new facility can help
the patient bridge the transition by providing information about the facility
and the vigorous program the patient
will encounter. The family should be encouraged to visit the facility and to bring
any questions or concerns to their liaison, while giving the patient positive input.
Rehabilitation requires the patient’s
active participation to achieve his or her
highest potential, and this participation
begins with planning. The patient’s individualized plan of care should be developed by the entire rehabilitation
team, which includes the patient and
significant others who make up the support system, as well as the primary physician, nurse, physiatrist, physical therapist, occupational therapist, vocational
counselor, dietitian, social worker, psychologist, and neuropsychologist. The
goals of the plan include learning to
manage neuromuscular deficits and being able to perform activities of daily living (ADLs) with enough independence
to function successfully in the home,
workplace, and social situations. Activities include proper positioning, rangeof-motion exercises, balancing and sitting, transfer activities, ambulation,
and use of equipment to aid ambulation
(if the patient will be able to walk with
the aid of braces, canes, or crutches) or
adjustment to being in a wheelchair.
Skin care is of great importance, as persons with paraplegia are at risk for
pressure sore development because of
their motor, sensory, and vasomotor deficits. Poor nutrition, infection, debilitation, edema, and prolonged immobility
are contributing factors. Assessment
and prevention of breakdown, as well as
treatment of most areas of broken skin,
fall within the purview of nursing, although severe pressure sores may require surgical débridement and plastic
surgery.
Cystometric studies help to assess
bladder function and determine the pa-
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paraplegia
1709
tient’s ability to participate in a bladder-retraining program, as opposed to
requiring catheter or condom-catheter
drainage methods. Bowel incontinence
also demands assessment of cause and
contributing factors (autonomic dysfunction, sacral injury, immobility, decreased food intake, esp. roughage). Incontinence is managed matter-of-factly,
getting the patient involved, observing
behavioral cues related to the need for
defecation, noting defecation habits and
using them for appropriate toileting,
and supporting the patient’s selfesteem. Bowel retraining involves establishing and maintaining a defecation
routine. All members of the rehabilitation team, but esp. mental health care
providers, are involved in helping the
patient and family cope with the lifestyle changes necessitated by the illness
or injury. Psychosocial care begins with
hearing the patient’s and family’s perceptions of the impact of the disability
and their expectations for the future,
and learning about their personalities,
previous coping abilities, and previous
adjustment patterns.
The adjustment to discharge to home
or group living adds its own set of transfer anxieties. The team teaches the patient and family any special procedures
they will need and determines home
and vehicle modifications needed to provide access for wheelchair or other necessary equipment. Group sessions with
others who have faced similar situations often help both the patient and
family. Initiating the move with a
“weekend pass,” followed by a return to
process feelings and activities, can also
help. It is important to note that rehabilitation, instead of ending with discharge, is an ongoing process central to
living a worthwhile life. Involvement in
paraplegic group activities including a
variety of sports (wheelchair basketball,
swimming) helps patients to focus on
what they can learn, enjoy, and accomplish.
alcoholic p. Alcoholic paralysis.
ataxic p. Lateral and posterior sclerosis of the spinal cord characterized by
slowly progressing ataxia and paresis.
cerebral p. Paraplegia from a bilateral cerebral lesion.
congenital spastic p. Infantile spastic p.
p. dolorosa Paraplegia due to pressure of a neoplasm on the posterior spinal cord and nerve roots; extremely
painful despite paralysis.
infantile spastic p. Spastic paraplegia that occurs in infants, usually due to
birth injury. SYN: congenital spastic
paraplegia.
peripheral p. Paraplegia due to pressure on, injury to, or disease of peripheral nerves.
parapsychology
Pott’s p. Pott’s paralysis. SEE: under
Pott, John Percivall.
primary spastic p. Paraplegia from
degeneration in corticospinal tracts.
superior p. Paralysis of both arms.
paraplegic (păr-ă-plē⬘jı̆k) [Gr. paraplegia, stroke on one side] Pert. to, or afflicted with, paraplegia.
paraplegiform (păr⬙ă-plĕj⬘ı̆-form) [⬙ ⫹
L. forma, form] Similar to paraplegia.
parapoplexy (păr-ăp⬘ō-plĕk⬙sē) [⬙ ⫹
apoplessein, to cripple by a stroke] A
mild or slight apoplexy with partial stupor; a stupor resembling apoplexy. SYN:
pseudoapoplexy.
parapraxia
(păr-ă-prăk⬘sē-ă)
[⬙
⫹
praxis, doing] Disturbed mental processes producing inaccuracy, forgetfulness, and tendency to misplace things
and make slips of speech or pen.
paraproctitis
(păr⬙ă-prŏk-tı̄⬘tı̆s)
[Gr.
para, beside, ⫹ proktos, anus, ⫹ itis,
inflammation] Inflammation of the tissues near the rectum.
paraprofessional (păr⬙ă-prō-fĕsh⬘ŭn-ăl)
A person with education and training in
a specific area of one of the professions
(e.g., medicine or law) who provides services in that profession as an extension
of an individual licensed to practice independently.
paraprostatitis (păr⬙ă-prŏs⬙tă-tı̄⬘tı̆s) [⬙
⫹ prostates, prostate, ⫹ itis, inflammation] Inflammation of the tissues
around the prostate.
paraprotein (păr⬙ă-prō⬘tē-ı̆n) An abnormal plasma protein, such as a macroglobulin, cryoglobulin, or immunoglobulin. SEE: paraproteinemia.
paraproteinemia (pă-ră-prō-tēn-ē⬘mēă)
The presence of abnormal or excessive
amounts of proteins, such as immunoglobulins or cryoglobulins, in the blood.
Paraproteinemias include amyloidosis,
cryoglobulinemia, cryofibrinogenemia,
cold IgM antibody disease, light chain
disease, monoclonal gammopathy, multiple myeloma, and Waldenström’s macroglobulinemia. Plasma exchange therapy, immunomodulating drugs, or
specific chemotherapeutic agents are
used to treat these disorders.
parapsoriasis (păr⬙ă-sō-rı̄⬘ă-sı̆s) [⬙ ⫹
psoriasis, an itching] A chronic disorder of the skin marked by scaly red lesions.
p. en plaque A form of parapsoriasis
that is often the precursor of mycosis
fungoides.
p. lichenoides chronica A form of
parapsoriasis that forms a widespread
network over the extremities and trunk
that is red to blue, sometimes resembling psoriasis or lichen planus.
parapsychology (păr⬙ă-sı̄-kŏl⬘ō-jē) A
brand of psychology that deals with alleged instances of extrasensory perception, telepathy, psychokinesis, clairvoyance, and associated phenomena.
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paraquat
parasympathetic
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host until maturity or spends its entire
life on its host.
specific p. A parasite that requires a
specific host in order to complete its life
cycle. parasitic (păr⬙ă-sı̆t⬘ı̆k), adj.
parasitemia (păr⬙ă-sı̄-tē⬘mē-ă) [⬙ ⫹ ⬙
⫹ haima, blood] The presence of parasites in the blood.
parasitic disease A disease resulting
from the growth and development of
parasitic organisms (plants or animals)
in or on the body.
parasiticide (păr⬙ă-sı̆t⬘ı̆-sı̄d) [⬙ ⫹ ⬙ ⫹
L. caedere, to kill] 1. Destructive to parasites. 2. An agent that kills parasites.
parasitism (păr⬘ă-sı̄t⬙ı̆zm) [⬙ ⫹ ⬙ ⫹ −ismos, condition] 1. The state or condition of being infected or infested with
parasites. 2. The behavior of a parasite.
parasitize (păr⬘ă-sı̆t-ı̄z⬙, −sı̄t-ı̄z⬙) To infest
or infect with a parasite.
parasitogenic (păr⬙ă-sı̄⬙tō-jĕn⬘ı̆k) [⬙ ⫹ ⬙
⫹ gennan, to produce] 1. Caused by
parasites. 2. Favoring parasitic development.
parasitologist (păr⬙ă-sı̄-tŏl⬘ō-jı̆st) [⬙ ⫹ ⬙
⫹ logos, word, reason] One who specializes in the science of parasitology.
parasitology (păr⬙ă-sı̄-tŏl⬘ō-jē) [⬙ ⫹ ⬙
⫹ logos, word, reason] The study of
parasites and parasitism.
parasitosis (păr⬙ă-sı̄-tō⬘sı̆s) [⬙ ⫹ ⬙ ⫹
osis, condition] A disease or condition
resulting from parasitism.
delusional p. The psychotic obsession or belief that one is infested with
insects or parasites.
parasitotropic (păr⬙ă-sı̄⬙tō-trŏp⬘ı̆k) [⬙ ⫹
⬙ ⫹ tropos, turning] Having an attraction for parasites, esp. certain drugs
that act chiefly on parasites in the body.
parasitotropism (păr⬙ă-sı̄-tŏt⬘rō-pı̆zm) [⬙
⫹ ⬙ ⫹ ⬙ ⫹ −ismos, condition] The
special affinity of drugs or other agents
for parasites.
parasomnia (păr⬙ă-sŏm⬘nē-ă) [⬙ ⫹ L.
somnus, sleep] Any of several abnormal experiences or behaviors occurring
during sleep (e.g., bruxism, night terrors, or sleepwalking). SEE: sleep disorder.
paraspadias (păr-ă-spā⬘dē-ăs) [Gr. paraspadein, to draw aside] A condition in
which the urethra has an opening
through one side of the penis.
parasternal (păr-ă-stĕrn⬘ăl) [⬙ ⫹ sternon, chest] Alongside the sternum.
p. region The area between the sternal border and parasternal line.
Parastrongylus (păr⬙ă-strŏn⬘jē-lus) The
former name for the roundworm genus
Angiostrongylus. SEE: Angiostrongylus.
parasuicide (pă⬙ră-sū⬘ı̆-sı̄d⬙) The intentional act of injuring or harming oneself
without intending to commit suicide.
parasympathetic (păr⬙ă-sı̆m⬙pă-thĕt⬘ı̆k)
[⬙
⫹
sympathetikos, sympathetic
nerve] Of or pert. to the craniosacral division of the autonomic nervous system.
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paraquat (păr⬘ă-kwăt) A toxic chemical
used in agriculture to kill certain weeds.
It damages the skin on contact and if
ingested may cause vomiting, diarrhea,
and liver, renal, and pulmonary disease.
This chemical is sometimes present as a
contaminant in marijuana.
pararectal (păr⬙ă-rĕk⬘tăl) [⬙ ⫹ L. rectum, straight] Close to the rectum.
parareflexia (păr⬙ă-rē-flĕk⬘sē-ă) An abnormal condition of the reflexes.
pararenal (păr⬙ă-rē⬘năl) [⬙ ⫹ L. ren,
kidney] Near the kidneys.
pararhotacism (păr⬙ă-rō⬘tă-sı̆zm) [⬙ ⫹
rho, Gr. letter R, ⫹ −ismos, condition]
Rhotacism.
parasacral (păr⬙ă-sā⬘krăl) [⬙ ⫹ L. sacrum, sacred] Close to the sacrum.
parasalpingitis (păr⬙ă-săl-pı̆n-jı̄⬘tı̆s) [⬙
⫹ salpinx, tube, ⫹ itis, inflammation]
Inflammation of the tissues around an
oviduct or a eustachian tube.
parasexuality (păr⬙ă-sĕks⬙ū-ăl⬘ı̆-tē) [⬙ ⫹
L. sexus, sex] Recombination without
sexual reproduction, as in fungi.
parasigmatism (păr⬙ă-sı̆g⬘mă-tı̆zm) [⬙
⫹ sigma, Gr. letter S, ⫹ −ismos, condition] Inability to pronounce “s” correctly; lisping.
parasite (păr⬘ă-sı̄t) [⬙ ⫹ sitos, food]
1. An organism that lives within, upon,
and at the expense of another organism
(its “host”), causing harm. 2. The
smaller or incomplete element of conjoined twins that is attached to and dependent on the more nearly normal twin
(autosite).
accidental p. A parasite infesting a
host that is not its normal host. SYN:
incidental parasite.
external p. A parasite that lives on
the outer surface of its host, such as a
flea, louse, mite, or tick. SYN: ectoparasite.
facultative p. A parasite capable of
living independently of its host at times;
the opposite of an obligate parasite.
incidental p. Accidental p.
intermittent p. A parasite that visits
its host at intervals for nourishment.
SYN: occasional parasite.
internal p. A parasite such as a protozoon or worm that lives within the
body of the host, occupying the digestive
tract or body cavities, or living within
body organs, blood, tissues, or cells.
SYN: endoparasite.
obligate p. A parasite completely dependent on its host; the opposite of a facultative parasite.
obligate intracellular p. A parasite
such as a virus or rickettsia that can reproduce only when within a living cell,
although it may survive outside cells.
occasional p. Intermittent p.
periodic p. A parasite that lives on
the host for short periods of time.
permanent p. A parasite, such as a
fluke or an itch mite, that lives on its
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parasympathetic nervous system
1711
parasympathetic nervous system The
craniosacral division of the autonomic
nervous system. Preganglionic fibers
originate from nuclei in the midbrain,
medulla, and sacral portion of the spinal
cord. They pass through the third, seventh, ninth, and tenth cranial nerves
and the second, third, and fourth sacral
nerves, and synapse with postganglionic neurons located in autonomic (terminal) ganglia that lie in the walls of or
near the organ innervated. SEE: autonomic nervous system for table.
Some effects of parasympathetic
stimulation are constriction of the pupil,
contraction of the smooth muscle of the
alimentary canal, constriction of the
bronchioles, slowing of the heart rate,
and increased secretion of the digestive
glands.
parasympatholytic
(păr⬙ă-sı̆m⬙pă-thōlı̆t⬘ı̆k) [⬙ ⫹ ⬙ ⫹ lytikos, dissolving]
Having a destructive effect on or blocking parasympathetic nerve fibers.
parasympathomimetic
(păr⬙ă-sı̆m⬙păthō-mı̆m-ĕt⬘ı̆k) [⬙ ⫹ ⬙ ⫹ mimetikos,
imitative] Producing effects similar to
those resulting from stimulation of the
parasympathetic nervous system.
parasynovitis (păr⬙ă-sı̆n⬙ō-vı̄⬘tı̆s) [⬙ ⫹
syn, with, ⫹ oon, egg, ⫹ itis, inflammation]
Inflammation of tissues
around a synovial sac.
parasystole (păr-ă-sı̆s⬘tō-lē) [⬙ ⫹ systole, contraction] An ectopically originating cardiac rhythm independent of
the normal sinus rhythm.
paratenic host A parasitized organism in
which the parasite thrives but does not
undergo development.
paratenon (păr⬙ă-tĕn⬘ŏn) [⬙ ⫹ tenon,
tendon] Fatty and areolar tissue that
fills the spaces within the facscia
around a tendon.
paratestis (păr⬙ă-tĕs⬘tı̆s) [⬙ ⫹ ⬙] The
anatomical structures immediately adjacent to the testis.
parathion (păr⬙ă-thı̄⬘ŏn) An agricultural
insecticide that is highly toxic to humans and animals.
p. poisoning Poisoning contracted by
accidental inhalation or ingestion while
working with the pesticide or because of
the inadvertent contamination of food
products eaten. Shortly after exposure,
headache, sweating, salivation, lacrimation, vomiting, diarrhea, muscular
twitching, convulsions, dyspnea, and
blurred vision occur. SEE: Poisons and
Poisoning Appendix.
parathormone (păr⬙ă-thor⬘mōn) [Gr.
para, beside, ⫹ thyreos, shield, ⫹ eidos, form, shape, ⫹ hormaein, to excite] Parathyroid hormone.
parathyroidectomy
(păr⬙ă-thı̄-roydĕk⬘tō-mē) [⬙ ⫹ ⬙ ⫹ ⬙ ⫹ ektome, excision] Surgical removal of one or more
of the parathyroid glands; used as a
treatment for hyperparathyroidism or
parathyroidectomy
neoplasm. Because the parathyroid
glands maintain serum calcium levels,
removal of the parathyroid glands may
produce profound hypocalcemia. SEE:
Nursing Diagnoses Appendix.
PATIENT CARE: The patient’s understanding of the procedure and postoperative care is assessed. The health care
provider gives additional information
and answers questions. Baseline levels
of serum potassium, calcium, phosphate,
and magnesium are obtained prior to
treatment and are carefully monitored
in both blood and urine throughout preoperative treatment and the postoperative period. Preoperatively serum calcium levels are reduced by forcing
fluids, limiting calcium in the diet, using intravenous normal saline solution
plus furosemide or ethacrinic acid to
promote diuresis and increase sodium
and calcium excretion, and administering sodium or potassium phosphate,
subcutaneous calcitonin, intravenous
biphosphonates, or intravenous plicamycin. During this period of hydration,
fluid intake and output are recorded,
with total intake of at least 3 L/day. All
urine is strained for calculi. Breath
sounds are auscultated frequently to assess the patient for volume overload.
Because the patient is at risk for pathologic fractures, safety precautions are
taken to minimize potential injuries.
The bed is kept in low position with side
rails in place. The patient is moved and
turned gently and carefully, and assisted with walking. Postoperatively,
all general patient care concerns apply.
The head of the patient’s bed should be
slightly elevated (semi-Fowler’s position) and the patient watched closely for
respiratory distress. A tracheostomy
tray should be available at the bedside
for emergency use. The patient is also
assessed for laryngeal nerve damage
(hoarseness or loss of voice) and hemorrhage. The operative site is checked
for swelling, dressings (and especially
the posterior neck) checked for bleeding,
and the head and neck supported with
sandbags to reduce edema, which can
result in pressure on the trachea and
other vital structures. The patient is assessed for signs of tetany (tingling
around the mouth or in the hands),
which should subside. Calcium gluconate or calcium chloride is kept available for intravenous administration
should neuromuscular irritability or
other signs of severe tetany occur. During the first 4 to 5 days postoperatively,
supplemental calcium may be needed as
serum calcium falls to low normal levels, and vitamin D or calcitriol also may
be given to help raise calcium levels. If
serum levels of magnesium or phosphate are low, magnesium phosphate or
sodium phosphate is administered in-
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parathyrotropic
parens patriae
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humans, the virus produces painless
smooth or warty lesions, called“ milker’s
nodules,” on the hands and arms. SEE:
milker’s nodules.
paravaginitis (păr⬙ă-văj-ı̆n-ı̄⬘tı̆s) [⬙ ⫹ ⬙
⫹ itis, inflammation] Inflammation of
the tissue surrounding the vagina.
paravenous (păr⬙ă-vē⬘nŭs) [⬙ ⫹ L.
vena, vein] Located close to a vein.
paravertebral (păr⬙ă-vĕr⬘tĕ-brăl) [⬙ ⫹
L. vertebralis, pert. to vertebrae]
Alongside or near the vertebral column.
paraxial (păr-ăk⬘sē-ăl) [⬙ ⫹ L. axis,
axis] On either side of the axis of the
body or one of its parts.
parazoon (păr⬙ă-zō⬘ŏn) [⬙ ⫹ zoon, animal] An animal that lives as a parasite
on another animal.
parched (părch) [ME. parchen] Extremely dry.
Paré, Ambroise (păr-ā⬘) French surgeon,
1510– 1590, who instituted certain refined techniques into surgery, obstetrics, and wound care.
parectropia (păr⬙ĕk-trō⬘pē-ă) [⬙ ⫹ ek,
out, ⫹ trope, a turn] Apraxia.
paregoric (păr-ĕ-gor⬘ı̆k) [L. paregoricus,
soothing] 1. Camphorated tincture of
opium, a narcotic-containing drug that
in large doses is poisonous; used in the
symptomatic treatment of diarrhea.
2. Soothing.
parelectronomic (păr⬙ē-lĕk⬙trō-nŏm⬘ı̆k)
[Gr. para, beside, ⫹ elektron, amber,
⫹ nomos, law] Not subject to electric
stimulus.
parencephalia (păr⬙ĕn-sĕ-fā⬘lē-ă) [⬙ ⫹
enkephalos, brain] A congenital defect
of the brain.
parencephalocele (păr⬙ĕn-sĕf⬘ă-lō-sēl) [⬙
⫹ ⬙ ⫹ kele, tumor, swelling] Herniation of the cerebellum through a defect
in the cranium.
parencephalous (păr⬙ĕn-sĕf⬘ă-lŭs) [⬙ ⫹
enkephalos, brain] A fetus with imperfect development of the cranium.
parenchyma (păr-ĕn⬘kı̆-mă) [Gr. parenkheim, to pour in beside] The essential
parts of an organ that are concerned
with its function in contradistinction to
its framework.
parenchymatitis (păr⬙ĕn-kı̆m⬙ă-tı̄⬘tı̆s) [⬙
⫹ itis, inflammation] Inflammation of
the parenchyma or substance of a gland.
parenchymatous
(păr⬙ĕn-kı̆m⬘ă-tŭs)
Concerning the essential tissues of an
organ.
parens patriae
(păr⬘ĕnz pă⬘trē-ē,
pah⬘rĕns pah⬘trē-ı̄) [L. “father of (his)
country,” a term of art in U.S. and U.K.
law] The power of the courts to protect
the interests of people who cannot protect themselves. In health care, this
power is sometimes invoked on behalf of
children (and other dependent or incompetent individuals) in order to provide
them with medical care that has been
refused by their family.
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travenously, or given orally or by retention enema. Listlessness, irritability,
and muscle weakness may indicate persistent hypercalcemia. Pain is monitored, and pain control is provided by
patient-controlled analgesia or by
round-the-clock preventive dosing.
Well-supported ambulation is begun
early in the postoperative period, as
pressure on long bones encourages bone
recalcification. Before discharge, the patient is taught about prescribed drug
therapies, including adverse effects that
should be reported, and about the importance of recognizing and seeking
medical attention for signs of calcium
deficiency. Instruction is provided in incisional care. The importance of ambulation and activity is emphasized. Arrangements are made for initial
postoperative visits to the surgeon and/
or endocrinologist.
parathyrotropic (păr⬙ă-thı̄-rō-trŏp⬘ı̆k) [⬙
⫹ ⬙ ⫹ tropikos, turning] Having an
affinity for the parathyroid gland.
paratope (păr⬘ă-tōp) [⬙ ⫹ topos, a
place] The site on an antibody to which
an antigen attaches. SEE: epitope.
paratransit (păr⬙ă-trănzı̆t) [⬙ ⫹ transit]
Transportation shared by a number of
individuals or agencies to deliver patients or nursing home residents to specific facilities or services. Paratransit
vehicles share some elements with municipal buses and private cars that meet
immediate personal transportation demands. They are typically wheelchairaccessible vans or buses. They can be
contracted to be available on-call or may
make scheduled trips between health
care facilities.
paratrichosis (păr⬙ă-trı̆-kō⬘sı̆s) [⬙ ⫹ trichosis, being hairy] An abnormality of
the hair or of its location.
paratrophic (păr⬙ă-trō⬘fı̆k) [⬙ ⫹ trophe,
nourishment] 1. Requiring a living organism for food; parasitic. 2. Pert. to abnormal nutrition.
paratyphlitis (păr⬙ă-tı̆f-lı̄⬘tı̆s) [⬙ ⫹ typhlos, blind, ⫹ itis, inflammation] Inflammation of the connective tissue
close to the cecum.
paratyphoid fever (păr-ă-tı̄⬘fŏyd) A rare
form of febrile gastroenteritis in Western societies, marked by fevers, abdominal pain, diarrhea, headache, and occasionally intestinal perforation. It is
caused by Salmonella paratyphi (A and
B strains) and related Salmonella species, typically contracted by travelers
who have visited tropical countries. Antibiotic treatments include ciprofloxacin
or chloramphenicol.
paraumbilical (păr⬙ă-ŭm-bı̆l⬘ı̆k-ăl) [⬙ ⫹
L. umbilicus, navel] Periumbilical.
paravaccinia (păr⬙ă-văk-sı̆n⬘ē-ă) A viral
disease that affects the udders of cows
and may be transmitted to humans. In
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parent
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parent (păr-ĕnt) [L. parens] A father or
a mother; one who begets offspring.
birth p. The biological parent(s) of a
child. SEE: surrogate parenting.
parentage, determination of (păr-ĕntj)
SEE: paternity test.
parental consent Permission granted to
a health care provider by a child’s
mother or father for health care services.
parental leave (păr-ĕn-tăl) The policy of
allowing one or both parents to have
leave from work following the birth of
their child.
parenteral (păr-ĕn⬘tĕr-ăl) [Gr. para, beside, ⫹ enteron, intestine] Denoting
any medication route other than the alimentary canal, such as intravenous,
subcutaneous, intramuscular, or mucosal. SEE: medication route.
p. nutrition SEE: total parenteral nutrition.
parenteral therapy A medicine or solution administered via a route other than
ingestion.
parenting (păr-ĕn-tēng) 1. Caring for
and raising a child or children. 2. Producing offspring.
impaired p. Inability of the primary
caretaker to create an environment that
promotes the optimum growth and development of the child. SEE: Nursing
Diagnoses Appendix.
impaired p., risk for Risk for inability of the primary caretaker to create,
maintain, or regain an environment
that promotes the optimum growth and
development of the child. SEE: Nursing
Diagnoses Appendix.
surrogate p. An alternative method
of childbearing for an infertile couple in
which the wife is unable to bear a child.
The surrogate mother agrees to be artificially inseminated by the husband’s
sperm and to relinquish the baby to the
couple. Another approach is to retrieve
eggs from the infertile wife and have
them impregnated in vitro by her husband. The fertilized ovum is then implanted in the surrogate mother. SEE:
fertilization, in vitro; GIFT.
parenting, readiness for enhanced A
pattern of providing an environment for
children or other dependent persons
that is sufficient to nurture growth and
development and can be strengthened.
SEE: Nursing Diagnoses Appendix.
paresis (păr⬘ĕ-sı̆s, pă-rē⬘sı̆s) [Gr. parienai, to let fall] 1. Partial or incomplete paralysis. SEE: paralysis. 2. A
dated but occasionally used term for
neurological complications of syphilis.
paretic (pă-rĕt⬘ı̆k), adj.
paresthesia (păr⬙ĕs-thē⬘zē-ă) [Gr. para,
beside, ⫹ aisthesis, sensation] An abnormal or unpleasant sensation that results from injury to one or more nerves,
often described by patients as numb-
Parkinson, James
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ness or as a prickly, stinging, or burning
feeling.
Berger’s p. Paresthesia of the legs
that occurs in young people.
pareunia (păr-ĕ-ū⬘nē-ă) [Gr. pareunos,
lying beside] Sexual intercourse. SEE:
dyspareunia.
paries (pā⬘rē-ĕs) pl. parietes [L., a wall]
The enveloping wall of any structure;
applied esp. to hollow organs.
parietal (pă-rı̄⬘ĕ-tăl) [L. parietalis]
1. Pert. to, or forming, the wall of a cavity. 2. Pert. to the parietal bone.
p. cell A large cell on the margin of
the gastric glands of the stomach that
secretes hydrochloric acid and intrinsic
factor. SYN: oxyntic cell. SEE: achlorhydria; anemia, pernicious; intrinsic
factor.
Parietaria judaica (păr-ı̄⬙ĕ-tār⬘ē-ă joodā⬘ı̆-kă) [L., Jew’s pellitory] ABBR:
Par j. The scientific name for a weed
found primarily in southern Europe and
the Mediterranean. Allergens derived
from the pollen of this weed are a common cause of seasonal allergies. SYN:
pellitory-of-the-wall.
parietofrontal (pă-rı̄⬙ĕ-tō-frŏn⬘tăl) Pert.
to both the parietal and frontal bones of
the skull or the parietal and frontal
lobes of the brain.
parieto-occipital (pă-rı̄⬙ĕ-tō-ŏk-sı̆p⬘ı̆-tăl)
Pert. to both the parietal and occipital
bones of the skull or the parietal and occipital lobes of the brain.
parietosquamosal
(pă-rı̄⬙ĕ-tō-skwămō⬘săl) Concerning the parietal bone
and squamous part of the temporal bone.
parietotemporal (pă-rı̄⬙ĕ-tō-tĕm⬘pō-răl)
Concerning the parietal and temporal
bones or lobes.
parietovisceral
(pă-rı̄⬙ĕ-tō-vı̆s⬘ĕr-ăl)
Concerning the wall of a body cavity and
the viscera within.
Parinaud, Henri (pă-rı̆-nō⬘) French ophthalmologist, 1844– 1905.
P.’s oculoglandular syndrome Conjunctivitis with palpable preauricular
lymph nodes.
P.’s
ophthalmoplegia
syndrome
Dorsal midbrain syndrome with palsy of
vertical gaze. It is caused by a brainstem lesion near the vertical gaze center. Sometimes associated with inability
to converge the eyes and poor pupillary
response to light.
pari passu (păr⬘ē-păs⬘ū) [L., with equal
speed] Occurring at the same time or
at the same rate; side by side.
parity (păr⬘ı̆-tē) [L. par, equal] Equality, similarity.
parity (păr⬘ı̆-tē) [L. parere, to bring forth,
to bear] The number of live children a
woman has delivered. SEE: multiparity;
nulliparity.
Parkinson, James (păr⬘kı̆n-sŭn) British
physician, 1755– 1824.
P. disease ABBR: PD. A common,
chronic degenerative disease of the cen-
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Parkinson, James
parkinsonism
top of rh
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viders, a neurologist, registered dietitian, physical therapist, occupational
therapist, and speech therapist. Patients should be monitored for the efficacy and safety of drug therapy, particularly when a new drug is prescribed.
Drug-drug interactions are common but
may be avoided with careful dose titration and prescribing. Elderly patients
are at increased risk for adverse effects
because of reduced drug tolerance and
should be assessed for postural hypotension, pulse irregularities, blepharospasm, and anxiety and confusion. Drug
dosages should be reduced if adverse
side effects occur. If patients have periods of immobility alternating with periods of severely impaired mobility, they
may need changes in their medication
schedule or new, additional medications. The patient and family are taught
safety measures to prevent injury
caused by falling, as well as swallowing
techniques to deal with dysphagia. Prescribed drugs are administered and
evaluated for desired effects and adverse reactions; the patient is instructed in their use and potential side
effects so that the dosage can be adjusted to minimize the side effects. The
nurse, physician, or occupational or
physical therapist teaches the patient
and family about safety measures to
prevent injury, about drug-related dietary restrictions, and about the need
for frequent small feedings to provide
needed fluids, calories, and dietary
bulk. Drinking at least 2 L/day of liquids
and eating a high-fiber diet help to establish a regular bowel routine; an elevated toilet seat and frame can help the
patient in moving from sitting to standing position. Independence is encouraged. The patient should plan daily activities for when he or she feels rested
to prevent fatigue, but even so, the patient needs to exercise regularly (active
and passive range of motion, walking,
massage, baths, carrying out activities
of daily living) to help relax muscles and
prevent contractures and muscle atrophy. Education about progression of the
disease and emotional support are provided; the family is assisted to recognize
and fulfill the patient’s need for intellectual stimulation and recreation. The patient is also referred to national organizations (e.g., the National Parkinson
Foundation, Inc.; www.parkinson.org)
for additional information.
P.’s facies The immobile, masklike,
facial expression that is a hallmark of
Parkinson disease and postencephalitic
states. SYN: Parkinson’s mask.
parkinsonian (păr⬙kı̆n-sōn⬘ē-ăn) Concerning Parkinson disease and/or its
characteristic signs and symptoms.
parkinsonism (păr⬘kı̆n-sŏn-ı̆zm⬙) A neurological disorder in which a few but not
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tral nervous system that produces progressive movement disorders and
changes in cognition and mood. Its hallmarks include a pill-rolling tremor of
the hands, muscular rigidity, loss of facial expression, difficulty initiating
movements (akinesia, bradykinesia),
and gait disturbances (esp. shuffling
gait, festination, and sometimes difficulty initiating forward movements).
Parkinson’s disease is usually found in
people over the age of 65. Its underlying
cause is unknown; it is clear, however,
that dopamine production by brain cells
in the substantia nigra is diminished in
the disease. Although PD often clusters
in families, it is uncertain whether this
is the result of genetics or of exposure to
common precipitating agents (viruses,
toxins, or drugs). In the U.S. about 1.5
million people have PD, with about
50,000 new cases diagnosed each year.
SEE: Nursing Diagnoses Appendix.
SYMPTOMS: Most patients report
gradual onset of fatigue, or malaise, followed by evidence of a tremor in one or
more extremities, typically a hand when
it is at rest. Such tremors increase during periods of anxiety or stress but decrease during purposeful motion or
sleep. Other common symptoms include
difficulty getting up from a chair or
turning over in bed, a change in vocal
quality (a softer, less audible, more monotonous voice), shuffling gait that becomes faster after a few steps (festination), and a stooped posture. As the
years pass, frequent falls may occur. Occasionally a tendency to fall backward
(retropulsion) replaces festination. Facial expressiveness may diminish (patients are said to have masklike facies),
swallowing often becomes impaired,
and handwriting may become smaller or
more cramped (micrographia).
TREATMENT: The goal of treatment
is to maintain function for as long as
possible and relieve symptoms. Medical
therapies include selegiline, levodopa/
carbidopa; dopamine agonists (e.g.,
bromocriptine); inhibitors of catechol-omethyltransferase (e.g., entacapone),
and monoamine oxidase-B inhibitors
(e.g., deprenyl). Surgical therapy, which
is performed at a small number of hospitals, may involve transplantation of
dopamine-secreting cells (fetal brain
tissue, nerve cells from other parts of
the patient’s body) into affected areas of
the brain or insertion of electrical brain
stimulators into the subthalamic nucleus, globus pallidus internus, or ventral intermediate nucleus. Physical
therapy is a very important part of the
treatment, helping to maintain muscle
tone and function.
PATIENT CARE: Teamwork benefits
the PD patient, who may require a social worker, nurses, primary care pro-
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1715
PAR nurse
all of the symptoms of Parkinson disease are present.
PAR nurse Postanesthesia recovery room
nurse.
parodontitis (păr⬙ō-dŏn-tı̄⬘tı̆s) [⬙ ⫹
odous, tooth, ⫹ itis, inflammation]
Inflammation of the tissues around a
tooth.
parodontium (păr⬙ō-dŏn⬘shē-ŭm) Periodontium.
parole (pă-rōl) [Fr. parole, short for parole d’honneur, word of honor] 1. In
psychiatry, the release of a patient from
the hospital on a trial basis. 2. In the
criminal justice system, the release of
an incarcerated individual to monitored
life in society at large.
paromphalocele (păr⬙ŏm-făl⬘ō-sēl⬙) [⬙ ⫹
omphalos, navel, ⫹ kele, tumor, swelling] A hernia or tumor close to the umbilicus.
paronychia (păr-ō-nı̆k⬘ē-ă) [⬙ ⫹ onyx,
nail] An acute or chronic infection of
the marginal structures about the nail.
SYN: felon; runaround; whitlow. SEE:
illus.
PARONYCHIA
SYMPTOMS: The nail edge shows
redness, swelling, and suppuration.
TREATMENT: Therapy may involve
moist heat application, oral antibiotics,
or surgical drainage.
paroophoritis (păr⬙ō-ŏf-ō-rı̄⬘tı̆s) [⬙ ⫹
oophoros, bearing eggs, ⫹ itis, inflammation] Inflammation of the tissues
around the ovary.
paroophoron (pă⬙-ō-ŏf⬘ă-rŏn⬙) [⬙ ⫹ oophoros, bearing eggs] A group of minute
tubules located in the mesosalpinx between the uterus and ovary. It is a vestigial structure consisting of the remains of the caudal group of
mesonephric tubules and is a homologue of the paradidymis of the male.
parophthalmia (păr-ŏf-thăl⬘mē-ă) [⬙ ⫹
ophthalmos, eye] Inflammation of the
tissue around the eye.
parorchidium (păr-or-kı̆d⬘ē-ŭm) [⬙ ⫹
orchis, testicle] Abnormal position, or
parovarian
nondescent, of a testicle. SYN: ectopia
testis.
parorexia (păr-ō-rĕk⬘sē-ă) [⬙ ⫹ orexis,
appetite] An abnormal craving for unusual foods. SEE: pica; taste.
parosmia (păr-ŏz⬘mē-ă) [⬙ ⫹ osme,
odor] Any disorder or perversion of the
sense of smell; a false sense of odors or
perception of those that do not exist.
Agreeable odors are considered offensive, and disagreeable ones pleasant.
Intravenous fluid therapy, esp. postoperatively, may create temporary parageusia and parosmia. SYN: parosphresia. SEE: cacosmia.
parosphresia, parosphresis
(păr⬙ŏsfrē⬘zē-ă, −sı̆s) [⬙ ⫹ osphresis, smell]
Parosmia.
parosteal (păr-ŏs⬘tē-ăl) Concerning the
outermost layer of the periosteum.
parosteitis, parostitis (păr-ŏs-tē-ı̄⬘tı̆s, −tı̄⬘
tı̆s) [Gr. para, beside, ⫹ osteon, bone,
⫹ itis, inflammation] Inflammation of
tissues next to the bone.
parosteosis, parostosis (păr⬙ŏs-tē-ō⬘sı̆s,
−tō⬘sı̆s) [⬙ ⫹ osteon, bone, ⫹ osis, condition] 1. Bone formation outside of the
periosteum. 2. Bone development in an
unusual location.
parotidectomy (pă-rŏt⬙ı̆-dĕk⬘tō-mē) [⬙
⫹ ous, ear, ⫹ ektome, excision] Excision of the parotid gland. This procedure is most often performed to excise a
malignancy and less often to remove a
stone (calculus) that cannot be extracted from Stenson’s duct in the
mouth.
PATIENT CARE: The patient’s understanding of the procedure and postoperative care is assessed, including suctioning and nasogastric tube for
drainage. The patient is encouraged to
express feelings and anxiety about the
surgery and alterations in body image.
After surgery, the patient is asked to
perform facial movements such as smiling, frowning, and exposing teeth to observe for possible damage to the facial
nerve. Pain is managed. Drainage
should be observed for excessive bleeding. A patent airway is maintained, and
good oral hygiene and nutrition are encouraged.
parotitis, parotiditis
(pă-rŏt⬙ı̆-dı̄⬘tı̆s,
pă⬙rō-tı̄⬘tı̆s) [⬙ ⫹ ous, ear, ⫹ itis, inflammation] Inflammation of the parotid gland.
granulomatous p. Granulomatous
inflammation of the parotid gland, usually due to tuberculosis or sarcoidosis.
suppurative p. Bacterial infection of
the parotid gland, usually in patients
with decreased salivary flow. It is often
caused by Staphylococcus aureus.
parous (păr⬘ŭs) [L. pario, to bear] Parturient; fruitful; having borne at least
one child.
parovarian (păr-ō-vā⬘rē-ăn) [Gr. para,
beside, ⫹ LL. ovarium, ovary] 1. Sit-
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parovariotomy
uated near or beside the ovary. 2. Pert.
to the parovarium, a residual structure
in the broad ligament.
parovariotomy (păr⬙ō-vā⬙rē-ŏt⬘ō-mē) [⬙
⫹ ⬙ ⫹ Gr. tome, incision] Removal of
a parovarian cyst.
parovaritis (păr⬙ō-vă-rı̄⬘tı̆s) [⬙ ⫹ LL.
ovarium, ovary, ⫹ Gr. itis, inflammation] Inflammation of the epoophoron.
parovarium (păr⬙ō-vā⬘rē-ŭm) Epoophoron.
paroxetine (păr-ŏx⬘ĕ-tēn) A selective serotonin reuptake inhibitor used as an
antianxiety agent and antidepressant.
It is administered orally to manage depression, panic, obsessive-compulsive
disorder, social anxiety, and general anxiety. It may be used as an adjunct to
psychotherapy.
paroxysm (păr⬘ŏk-sı̆zm) [Gr. paroxysmos, irritation] 1. A sudden, periodic
attack or recurrence of symptoms of a
disease; an exacerbation of the symptoms of a disease. 2. A sudden spasm or
convulsion of any kind. 3. A sudden
emotional state, as of fear, grief, or joy.
paroxysmal (păr⬙ŏk-sı̆z⬘măl) Occurring
repeatedly and without warning.
p. nocturnal hemoglobinuria SEE:
under hemoglobinuria.
paroxysmal nocturnal dyspnea SEE:
dyspnea, paroxysmal nocturnal.
Parrot, Joseph Marie Jules
particle
top of rh
base of rh
forms part of the lateral wall of the
skull.
p. tensa membranae tympani The
larger portion of the tympanic membrane, a tightly stretched membrane lying inferior to the malleolar folds. SEE:
p. flaccida membranae tympani.
Parse, Rosemarie (părsē) A nursing educator who developed the Theory of Human Becoming and the Human Becoming School of Thought. SEE: Nursing
Theory Appendix.
Parsonage-Turner syndrome Idiopathic
brachial plexopathy.
pars planitis (părs plā-nı̄⬘tı̆s) Inflammation of the anterior chamber, the anterior vitreous, and/or the peripheral
retina of the eye. It commonly causes
floaters and blurring of vision. The disease may occur in childhood or adulthood. It is associated with autoimmune
diseases such as multiple sclerosis or
sarcoidosis and infectious diseases such
as Lyme disease, syphilis, or tuberculosis. Treatments include treatment of
the underlying illness and/or laser or
cryotherapy. SYN: intermediate uveitis.
part, presenting (părt) Before delivery,
the fetal anatomical structure nearest
the internal cervical os, identified by
sonogram or palpation during vaginal
examination. SEE: presentation for illus.
partes (păr⬘tēs) Pl. of pars.
parthenogenesis
(păr⬙thĕn-ō-jĕn⬘ĕ-sı̆s)
[Gr. parthenos, virgin, ⫹ genesis, generation, birth] Reproduction arising
from a female egg that has not been fertilized by the male; unisexual reproduction.
participant observation (păr-tı̆-sı̆-pănt)
A method of field research in which the
investigator observes and records information about the characteristics of a
setting through experience as a participant in that setting.
participation In the context of rehabilitation, a person’s involvement in life situations despite physical impairments,
activity limitations, or contextual factors, such as social or physical barriers
in the environment. Participation in life
activities, tasks, and roles is an aspect
of living that is considered important
within the framework of the World
Health Organization’s International
Classification of Functioning, Disability, and Health (ICF). SEE: International Classification of Functioning,
Disability, and Health.
particle (păr-tı̆kl) [L. particula] 1. A
very small piece or part of matter; a tiny
fragment or trace. 2. One of several subatomic components of the nuclei of radioactive elements, such as alpha and
beta particles. 3. Attraction particle or
centriole of the nucleus of a cell. 4. Virion.
alpha p. A charged particle emitted
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(păr-ō⬘)
French physician, 1829– 1883.
P.’s disease 1. Osteochondritis that
occurs in infants with congenital syphilis. 2. A form of dwarfism that is transmitted as an autosomal dominant.
P.’s nodes Bony nodules on the skull
of infants with congenital syphilis. Also
called Parrot’s sign.
P.’s pseudoparalysis
Pseudoparalysis caused by syphilitic osteochondritis.
P.’s sign Parrot’s nodes.
P.’s ulcer Lesions seen in thrush or
stomatitis.
parrot fever (păr-rŭt) Psittacosis.
Parry’s disease (păr⬘ēz) [Caleb H. Parry,
Brit. physician, 1755– 1822] Hyperthyroidism.
Parry-Romberg
syndrome
(păr⬘ē
rŏm⬘bĕrg) Progressive hemifacial atrophy.
pars (părz) pl. partes [L.] A part; portion of a larger structure.
p. flaccida membranae tympani The
portion of the membrane of the eardrum
that fills the notch of Rivinus. This portion of the drum is not taut. SYN:
Shrapnell’s membrane.
p. interarticularis The region between the superior and inferior articulating facets of a vertebra; the region
where fracture frequently occurs with
spondylolysis.
p. squamosa ossis temporalis The
flat portion of the temporal bone that
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1717
from a radioactive substance made up of
a helium nucleus consisting of two protons and two electrons. The particle has
very low penetrability, but an extremely
high linear energy transfer.
beta p. Beta ray.
Dane p. SEE: Dane particle.
elementary p. The subatomic parts
of the atomic nucleus.
particle beam therapy The use of heavy
nuclear particles (e.g., protons, neutrons, or helium ions) to bombard and
destroy diseased tissues, esp. cancers.
SYN: hadron therapy.
particulate (păr-tı̆k⬘ū-lāt) Made up of
particles.
Partin coefficient table A statistical tool
that relies on prostate-specific antigen
(PSA) levels and Gleason scores to predict whether a male with prostate cancer will have disease that has spread beyond the prostate gland.
partner notification A public health practice in which the sexual contacts of persons diagnosed with sexually transmitted diseases are made aware of their
exposure and are advised to seek medical attention. Two methods are used to
contact persons at risk. They may be notified directly by their sexual partner or
partners, or they may be contacted by
public health authorities who have obtained their names from their sexual
partner or partners.
parts per million (părts) ABBR: PPM;
ppm. The concentration of a solute in a
liquid or gas. For example, a pollutant
such as soot may be said to be present
in air at a level of 50 parts per million
(parts of air). The units also may be expressed as weight of one substance to
the weight of another or the volume of a
fluid in the volume of another.
parturient (păr-tū⬘rē-ĕnt) [L. parturiens,
in labor] Concerning childbirth or parturition; giving birth.
parturifacient (păr-tū-rı̆-fā⬘shĕnt) [⬙ ⫹
facere, to make] 1. Inducing or accelerating labor. 2. A drug used to cause or
hasten delivery of the fetus.
parturition (păr-tū-rı̆sh⬘ŭn) [L. parturitio] The act of giving birth to young.
SYN: childbirth. SEE: delivery; labor.
party (păr⬘tē) A person or entity who
acts as petitioner, plaintiff, or defendant
in a legal action.
parulis (pă-roo⬘lı̆s) [Gr. para, beside, ⫹
oulon, gum] Gumboil.
paruresis (păr⬙ū-rē⬘sı̆s) [⬙ ⫹ ⬙] A social
phobia characterized by an inhibition to
urinate in the presence of others. It is
also known as “shy kidney” or “shy bladder” syndrome.
parvocellular (păr⬙vō-sĕl⬘ū-lı̆r) [L. parvus, small ⫹ ⬙] Having a small cell
body. It is said esp. of cells found in the
lateral geniculate nucleus of the thalamus.
parvovirus (păr⬙vō-vı̄⬘rŭs) [⬙ ⫹ virus,
passivity
top of rh
base of rh
poison] A group of viruses similar to
adeno-associated viruses. They are
pathogenic in animals and humans.
p. B19 SEE: erythrovirus B19.
parvule (păr⬘vūl) [L. parvulus, very
small] A small pill, pellet, or granule.
PAS, PASA para-aminosalicylic acid.
pascal (păs-kăl⬘) A unit of pressure
equal to the force of one newton acting
uniformly over 1 m2. SEE: newton; SI
Units Appendix.
Paschen bodies (pă⬘shĕn) [Enrique
Paschen, Ger. pathologist, 1860– 1936]
Intracellular particles of smallpox, visualized microscopically.
PASG pneumatic anti-shock garment.
SEE: MAST.
passage (păs⬘ăj) [ME., to pass] 1. A
channel between cavities and body
structures or with the external surface
of an organ. 2. An evacuation of the bowels. 3. Introduction of a probe or catheter. 4. Incubation of a pathogenic organism, esp. a virus, in one or a series of
tissue cultures or living organisms. 5. In
cell biology, a cycle of cellular proliferation of cells maintained in culture.
passion (păsh⬘ŭn) [L. passio, suffering]
1. Suffering. 2. Great emotion or zeal.
heat of p. In forensic medicine, a
state of mind that might influence one’s
propensity to commit violent or aggressive acts.
passion flower An herbal remedy from
the American shrub or vine Passiflora
incarnata, used primarily as a sedative
or calming agent. Its effectiveness has
not been systematically tested in human beings.
passivation (păs⬙ı̆-vā⬘shı̆n) [⬙] The stabilization and protection of a surface
from outside influences, e.g., the treatment of an atherosclerotic plaque to
keep it from rupturing or of a metal to
keep it from corroding.
passive (păs⬘ı̆v) [L. passivus, capable of
suffering] 1. Not reacting or participating. 2. Secondhand; unintentional (e.g.,
passive smoking). 3. Submissive.
passive smoking The exposure of nonsmokers to the toxic gases released by
the burning of tobacco products in their
homes, workplaces, or recreational environments. Exposure to environmental
tobacco smoke has been linked to allergies, asthma, cardiovascular diseases,
lung diseases, and stroke. Passive
smoking causes about 30,000 deaths
from heart disease and another 3,000
lung disease deaths annually in the U.S.
SYN: secondhand smoking. SEE: tobacco.
passivism (păs⬘ı̆-vı̆zm) [⬙ ⫹ Gr. −ismos,
condition] 1. Passive behavior or character. 2. Sexual perversion with subjugation of the will to another.
passivity (păs-sı̆v⬘ı̆-tē) [L. passivus, capable of suffering] 1. Dependence on
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1718
others. 2. A reluctance to be self-determined or assertive.
Pasteur, Louis (păs-stŭr⬘) [Fr. chemist
and bacteriologist, 1822– 1895] Founder
of microbiology. He developed the technique of eliminating bacteria from food
products and produced the first vaccines.
Pasteurella (păs-tă-rĕl⬘ă) [Louis Pasteur] A genus of gram-negative coccobacilli that causes disease in animals
and humans. Pathogens once classed in
this genus include Yersinia pestis (the
microbe that causes plague) and Francisella tularensis (tularemia).
P. multocida A species found in the
oral cavities of cats, dogs, and other animals. It may be transmitted to humans
by animal bites, and may cause cellulitis, abscesses, osteomyelitis, pneumonia, peritonitis, or meningitis. Penicillins, doxycycline, or cephalosporins are
used to treat the infection.
pasteurellosis (păs⬙tĕr-ĕ-lō⬘sı̆s) A disease caused by infection with bacteria of
the genus Pasteurella.
pasteurization
(păs⬙tūr-ı̄-zā⬘shŭn)
[Louis Pasteur] The process of heating
a fluid at a moderate temperature for a
definite period of time to destroy undesirable bacteria without changing to
any extent the chemical composition of
the fluid. In pasteurization of milk,
pathogenic bacteria are destroyed by
heating at 62⬚C for 30 min, or by “flash”
heating to higher temperatures for less
than 1 min. The pasteurization process,
reducing total bacterial count of the
milk by 97% to 99%, is effective because
the common milk-borne pathogens (tubercle bacillus, and Salmonella, Streptococcus, and Brucella organisms) do
not form spores and are quite sensitive
to heat. SEE: flash method; milk.
Pastia’s lines A characteristic physical
finding in patients with scarlet fever, in
which red or pink petechial lines appear
in skin creases (e.g., in the skin in front
of the elbow or the hip joint).
pastille (păs-tēl⬘, −tı̆l⬘) [L. pastillus, a little roll] 1. A medicated disk used for local action on the mucosa of the throat
and mouth. SYN: lozenge; troche. 2. A
small cone used to fumigate or scent the
air of a room.
past-pointing (păst-pŏyn-tēng) The inability to place a finger or some other
part of the body accurately on a selected
point; seen esp. in cerebellar disorders.
PAT (păt) Paroxysmal atrial tachycardia. The contemporary, and more accurate, term is paroxysmal supraventricular tachycardia (PSVT).
patau syndrome Trisomy 13.
patch (păch) [ME. pacche] 1. A small
circumscribed area distinct from the
surrounding surface in character and
appearance. 2. A drug delivery system
patella
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that enhances the uptake of a medicine
through the skin. 3. Any substance or
object used to repair a defect in the
body.
blood p. A clot of a patient’s blood
placed over the dura to repair a cerebrospinal fluid leak that may be caused by
a lumbar puncture, esp. one performed
with a large-bore needle. It is used to
treat post– lumbar puncture headache.
SYN: epidural blood patch. SEE: post–
lumbar puncture headache.
cotton-wool p., cotton-wool spot A
fluffy looking lesion in the nerve fiber
layer caused by infarction; usually seen
in hypertension, diabetes, collagen vascular disease, or AIDS.
epidural blood p. Blood patch.
herald p. A solitary oval patch of
scaly skin that appears several days before the generalized rash of pityriasis
rosea.
Hutchinson’s p. SEE: under Hutchinson, Sir Jonathan.
mucous p. A syphilitic eruption having an eroded, moist surface; usually on
the mucous membrane of the mouth or
external genitals, or on a surface subject
to moisture and heat.
Peyer’s p. SEE: Peyer’s patch.
salmon p. An oval pale retinal hemorrhage seen in sickle cell disease. SEE:
Hutchinson’s patch.
smoker’s p. Leukoplakia of the oral
mucosa.
white p. A white, thickened area of
oral mucosa that will not rub off and
represents a benign hyperkeratosis.
SEE: leukoplakia.
patch test A skin test in which a low concentration of a presumed allergen is applied to the skin beneath an occlusive
dressing. The test is the primary
method used to determine the presence
of allergic contact dermatitis. If the concentration of the agent is too high or an
allergy exists to the material used in the
dressing, false-positive reactions can occur as a result of local irritation. Falsenegative reactions may result if the concentration of the suspected allergen is
too low, or if the duration of the test is
too short. Commercially available, standardized kits to facilitate patch testing
include the T.R.U.E. test and Finn
Chambers. SEE: illus.; skin test.
patella (pă-tĕl⬘ă) pl. patellae [L., a small
pan] A lens-shaped sesamoid bone situated in front of the knee in the tendon
of the quadriceps femoris muscle. SYN:
kneecap. SEE: osteochondritis dissecans.
p. alta A high-riding patella (high positioning of patella). When a person is
standing, the patella rests in a more superior position than normal.
p. baja A low-riding patella (low positioning of patella). When a person is
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patella
APPLYING PATCH TEST
standing, the patella rests in a more inferior position than normal.
bipartite p. The developing patella
that matures from two centers rather
than one. This usually congenital condition causes no symptoms but may be
mistaken for a fracture.
dislocated p. Displacement of the
patella from its normal position in the
femoral trochlea. Most patellar dislocations are marked by obvious deformity
and occur laterally. They result in the
tearing or stretching of the medial patellar retinaculum and the oblique fibers of the vastus medialis muscle. The
patella may spontaneously reduce as
the patient attempts to straighten the
knee.
floating p. A patella that rides up
from the condyles owing to a large effusion in the knee.
fracture of p. A break in the continuity of the kneecap. Treatment may
consist of suturing the bone fragments.
A long-leg immobilizer is applied for 6
to 8 weeks. Following removal of the
brace, gradual exercise may be started
and weight placed on the leg for a few
weeks, after which the patient may
walk.
hypermobile p. Excessive medial
and/or lateral motion of the patella. A
medially hypermobile patella can be
moved greater than 75% of its width medially. A laterally hypermobile patella
can be moved greater than 75% of its
width laterally. SEE: hypomobile p.; apprehension test.
ETIOLOGY: Increased medial patellar hypermobility can result from laxity
of the lateral patellar retinaculum. Lateral patellar hypermobility indicates
laxity of the medial patellar retinaculum and/or weakness of the oblique fibers of the vastus medialis.
SYMPTOMS: Increased motion of the
patella within the femur’s trochlea can
lead to chondromalacia patellae, pro-
patellofemoral pain syndrome
ducing pain in weight-bearing activities, esp. squatting or climbing or descending stairs. Lateral patellar
hypermobility is a predisposition to patellar dislocation or subluxation.
TREATMENT: Treatment and rehabilitation consists of strengthening the
muscles on the side opposite the hypermobility. Neuromuscular re-education
may be needed to restore the normal recruitment sequence of the oblique fibers
of the vastus medialis and the vastus
lateralis.
hypomobile p. Lack of normal medial and/or lateral motion of the patella.
A medially hypomobile patella cannot
be moved more than 25% of its width
medially. A laterally hypomobile patella
cannot be moved more than 15% of its
width laterally. SEE: hypermobile p.
ETIOLOGY: Medial hypomobility often results from adhesions of the lateral
patellar retinaculum or tightness of the
iliotibial band. Lateral hypomobility
can result from tightness of the medial
patellar retinaculum or hypertrophy or
spasm of the oblique fibers of the vastus
medialis.
SYMPTOMS: The patient will complain of pain and demonstrate decreased strength during weight-bearing
activities. Improper tracking of the patella as the result of hypomobility can
lead to chondromalacia patellae.
TREATMENT: Physical agents such
as moist heat and/or ultrasound and
manual therapy techniques can be used
to encourage the elasticity of the offending tissues. A surgical release of the patellar retinaculum may be required.
rider’s painful p. Tenderness and
pain in the patella from horseback riding.
squinting p. A disorder in which the
patella appears to be pointing inward
when the patient is standing; caused by
excessive femoral anteversion.
patellapexy (pă-tĕl⬘ă-pĕk⬙sē) [L. patella,
small pan, ⫹ Gr. pexis, fixation] Fixation of the patella to the lower end of
the femur to stabilize the joint.
patellar (pă-tĕl⬘ăr) Concerning the patella.
patellectomy (păt⬙ĕ-lĕk⬘tō-mē) [⬙ ⫹ Gr.
ektome, excision] Surgical removal of
the patella.
patelliform (pă-tĕl⬘ı̆-form) [⬙ ⫹ forma,
shape] Shaped like the patella.
patellofemoral (pă-tĕl⬙ō-fĕm⬘ō-răl) Concerning the patella and femur.
patellofemoral pain syndrome Pain in
the knee that occurs with exertion (e.g.,
walking upstairs) and is associated with
stiffness after prolonged sitting and tenderness when the patella is compressed
on the femoral condyle or when it is
moved laterally. SEE: patellofemoral instability.
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1720
patency
(pā⬘tĕn-sē) [L. patens, open]
The state of being freely open.
patent (păt⬘ĕnt, pā⬘tĕnt) Wide open; evident; accessible.
patent ductus arteriosus Persistence, after birth, of a communication between
the main pulmonary artery and the
aorta. This condition in preterm infants
has been treated successfully with
drugs, such as indomethacin, that inhibit prostaglandin synthesis. SEE:
prostaglandin.
paternalism (pă-tĕr-năl-ı̆zm) A type of
medical decision making in which
health care professionals exercise unilateral authority over patients. When
patients are competent to make their
own choices and health care professionals seek to act in the patients’ best interests, shared decision making is preferable, because it encourages dialogue,
preserves autonomy, fosters responsibility, and allows for adaptation.
paternity test (pă-tĕr-nı̆-tē) A test to determine the father of a child. Because
paternity is a clinical estimate, there is
the need to have tests to determine
whether it would be possible for an individual to have fathered a specific
child. At one time, the tests used to
prove or exclude the possibility of paternity used blood type data from the child
and the suspected father. Tests involving the technique of molecular genetic
fingerprinting and of determining genetic markers are available and have
the ability to exclude almost all except
the father. Use of these techniques
makes it possible to distinguish differences between the genotype of all individuals except identical twins.
path (păth) A particular course that is
followed or traversed. SEE: pathway.
circulation p. SEE: circulation path.
p. of closure The path traversed by
the mandible as it closes when its neuromuscular mechanisms are in a balanced functional state.
condyle p. The path traversed by the
condyle during various mandibular
movements.
incisor p. An arc described by the incisal edge of the lower incisors when the
mandible closes to normal occlusion.
p. of instantaneous center of rotation ABBR: PICR. The plotted trajectory of the axis of rotation of a joint
through its entire range of movement.
The center of rotation moves due to
translation, the accessory gliding or
sliding motion that accompanies the rotation. The fact that this is instantaneous infers that the PICR is not constant, but changes with the moment.
PATIENT CARE: Deviation from the
ideal PICR for any joint may result from
muscle strength or length imbalance,
internal joint derangement, or joint capsule restriction. These conditions may
pathogen-associated molecular
patterns
occur because of previous joint surgery,
scar tissue, traumatic injury, or simply
from aging, and may affect the quality,
quantity, efficiency, or pain of joint
movement and gait mechanics. Physical
therapists try to improve their patients’
awareness of their center of gravity and
of shifts that can throw this off balance by employing balance exercises
and posture training. Correct patient
positioning for bed or chair rest should
be practiced by all health care providers, as asymmetry can affect the patient’s comfort and lead to further joint
concerns over time. An orthotist or prosthetist measuring and fitting a patient
for any joint brace must consider the desired PICR, as the brace must allow the
joint to move through full PICR. If
proper joint movement is restricted, the
device could lead to further pathology.
path- SEE: patho-.
pathergy (păth⬘ĕr-jē) [Gr. pathos, disease, suffering, ⫹ ergon, work] A skin
reaction at the site of a sterile needle
prick that results in a pustule and reddened skin. This reaction, which lasts 2
to 5 days, is a sign of skin hyperreactivity consistent with Behçet’s syndrome.
pathetic (pă-thĕt⬘ı̆k) [L. patheticus]
1. Pert. to, or arousing, the emotions of
pity, sympathy, or tenderness. 2. Pert.
to the trochlear nerve.
pathfinder (păth-fı̄n-dĕr) [AS. paeth,
road, ⫹ findan, to locate] 1. An instrument for locating stricture of the
urethra. 2. A dental instrument for tracing the course of root canals.
patho-, path- [Gr. pathos, disease, suffering] Combining form meaning disease.
SEE: -pathy.
pathoanatomy (păth⬙ŏ-ă-năt⬘ō-mē) Anatomic pathology.
pathobiology (păth⬙ō-bı̄-ŏl⬘ō-jē) Pathology.
pathodontia (păth⬙ō-dŏn⬘shē-ă) [⬙ ⫹
odous tooth] The science of dental pathology.
pathogen (păth⬘ō-jĕn) [⬙ ⫹ gennan, to
produce] A microorganism capable of
producing a disease.
bloodborne p. A pathogen present in
blood that can be transmitted to an individual who is exposed to the blood or
body fluids of an infected individual.
Three common bloodborne pathogens
are hepatitis C, hepatitis B, and human
immunodeficiency virus 1 (HIV-1). SEE:
hepatitis B; human immunodeficiency
virus; Standard Precautions Appendix.
opportunistic p. A microorganism
that is usually harmless but may become pathogenic in certain circumstances, e.g., when it is introduced into
a part of the body where it normally
does not reside or when it infects an immunocompromised host.
pathogen-associated molecular patterns
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pathogenesis
1721
ABBR: PAMP. Any of several molecular sequences associated with or found
in many different disease-causing microorganisms to which the innate immune system reacts without initiating
an antigen-antibody response. Examples of pathogen-associated molecular
patterns are
1. bacterial DNA,
2. lipoteichoic acids found in the cell
walls of gram-positive bacteria,
3. lipopolysaccharides found in the
cell walls of gram-negative bacteria,
and
4. sugars like glucans or mannose,
found in fungi or bacteria, respectively,
but not in mammalian cells.
pathogenesis (păth⬙ō-jĕn⬘ĕ-sı̆s) The origin and development of a disease. SYN:
pathogeny.
bacterial p. The development of a
bacterial disease. There are three
stages: entry and colonization in the
host, bacterial invasion and reproduction with the production of toxic substances, and the response of the host.
The mere presence of an organism in
the body does not necessarily mean that
disease will follow. This progression of
the infection will depend upon a number
of interacting factors, including the virulence and number of invading organisms and the ability of the host’s immune system to destroy the bacteria.
pathogenetic, pathogenic (păth⬙ō-jĕnĕt⬘ı̆k, −jĕn⬘ı̆k) Productive of disease.
SYN: morbific.
pathogenicity (păth⬙ō-jĕ-nı̆s⬘ı̆-tē) [⬙ ⫹
gennan, to produce] The state of producing or being able to produce pathological changes and disease.
pathogen-reduced plasma Plasma that
has been treated with detergents, methylene blue, or ultraviolet energy in order
to reduce the likelihood that it will
transmit infection during transfusion.
pathogeny (păth-ŏj⬘ĕn-ē) Pathogenesis.
pathognomonic
(păth⬙ŏg-nō-mŏn⬘ı̆k)
[Gr. pathognomonikos, skilled in diagnosing] Indicative of a disease, esp. its
characteristic symptoms.
pathognomy (păth-ŏg⬘nō-mē) [Gr. pathos, disease, suffering, ⫹ gnome, a
means of knowing] Diagnosing the
cause of an illness after careful study of
the signs and symptoms of a disease.
pathologic, pathological (păth-ō-lŏj⬘ı̆k,
−ı̆-kăl) [Gr. pathos, disease, suffering,
⫹ logos, word, reason] 1. Concerning
pathology. 2. Diseased; due to a disease.
SYN: morbid.
pathologist (pă-thŏl⬘ō-jı̆st) [⬙ ⫹ logos,
word, reason] A medical professional
trained to examine tissues, cells, and
specimens of body fluids for evidence of
disease.
pathology (pă-thŏl⬘ō-jē) [Gr. pathos, disease, suffering, ⫹ logos, word, reason]
1. The study of the nature and cause of
pathotype
disease, which involves changes in
structure and function. 2. A condition
produced by disease.
anatomic p. The field of pathology
that deals with structural changes in
disease.
cellular p. Pathology based on microscopic changes in body cells produced by
disease.
chemical p. The study of chemical
changes that occur in disease.
clinical p. Pathology that uses clinical analysis and other laboratory procedures in the diagnosis and treatment
of disease.
comparative p. The study of the distinctions between human diseases and
the diseases that affect other animals,
or plants.
dental p. The science of diseases of
the mouth. SYN: oral pathology.
experimental p. The study of diseases induced artificially and intentionally, esp. in animals.
functional p. The study of alterations
of functions that occur in disease processes without associated structural
changes.
geographical p. Pathology in its relationship to climate and geography.
humoral p. Pathology of the fluids of
the body.
medical p. Pathology of disorders
that are not accessible for surgical procedures.
molecular p. The study of the pathological effects of specific molecules.
oral p. Dental p.
special p. Pathology of particular
diseases or organs.
surgical p. The application of pathological procedures and techniques for
investigating tissues removed surgically.
pathomechanics
(păth⬙ō-mı̆-kăn⬘ı̆-ks)
Changes in the normal biomechanical
function of a joint, an extremity, or the
torso as the result of trauma or disease.
SEE: biomechanics.
pathomimesis (păth⬙ō-mı̆m-ē⬘sı̆s) [Gr.
pathos, disease, suffering, ⫹ mimesis,
imitation] Intentional (conscious or unconscious) imitation of a disease. SYN:
pathomimicry.
pathomimicry (păth⬙ō-mı̆m⬘ı̆-krē) Pathomimesis.
pathophysiology (păth⬙ō-fı̆z⬙ē-ŏl⬘ō-jē) [⬙
⫹ physis, nature, ⫹ logos, word, reason] The study of how normal physiological processes are altered by disease.
pathopsychology (păth⬙ō-sı̄-kŏl⬘ō-jē) [⬙
⫹ psyche, soul, ⫹ logos, word, reason]
The branch of psychology dealing with
mental processes during disease.
pathotype (păth⬘ō-tı̄p) [Gr. pathos, disease, ⫹ typos, type] A disease-causing variant of a microorganism. It is distinguishable from other members of its
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pathway
1722
species by its virulence and by unique
molecular markers.
pathway (păth-wā) 1. A path or a
course; e.g., a pathway formed by neurons (cell bodies and their processes)
over which impulses pass from their
point of origin to their destination. 2. A
metabolic sequence; a predictable series
of chemical reactions, such as those of
cellular respiration. 3. A course of study
or a means to attain professional certification.
afferent p. A sensory pathway from
a receptor to the central nervous system.
biosynthetic p. The chemical and
metabolic events that lead to the formation of substances in the body.
central p. An axon tract within the
brain or spinal cord.
clinical p. A method used in health
care as a way of organizing, evaluating,
and limiting variations in patient care.
Development of a clinical pathway usually begins with establishment of a multidisciplinary committee that examines
data to determine which patients will
benefit most. Usually, diagnoses that
involve costly or complex care (e.g., multidisciplinary care) or common illnesses
are selected for study. The following aspects of care are evaluated: consultations and assessments, tests and treatments, nutrition and medications,
activity and safety, and teaching and
discharge planning. Clinical pathways
address timelines, actions, and outcomes, and ensure that essential components of care are provided.
Agencies using clinical pathways report the following advantages: reduced
length of stay for patients in given diagnosis-related groups (DRGs); greater
accountability for patient care; greater
patient and family satisfaction; enhanced staff and physician satisfaction
and communication; an improved and
integrated process for care delivery;
minimal prejudices and elitism between
departments; lower patient charges and
costs; and less time spent on documentation. SYN: care map.
complement alternative p. A complement cascade initiated by a foreign
protein, usually a bacterium. SEE: complement.
complement classic p. A complement cascade initiated by an antibodyantigen reaction that activates complement factor 1 (C1). SEE: complement.
conduction p. A group of fibers in the
heart, nerves, spinal cord, or brain that
conduct impulses that trigger responses
in the same or other tissues.
critical p. Clinical p.
efferent p. A pathway from the central nervous system to an effector.
Embden-Meyerhof p. SEE: EmbdenMeyerhof pathway.
Patient Advise and Consent
Encounter
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fifth p. A form of postgraduate medical education, in which graduates of international medical training programs
undergo supervised clinical clerkships
in the U.S. to complete their residency
training.
p. of incidence The path of a penetrating foreign object from the point of
entry into the body to the point where it
stops (e.g., the path of a bullet from
where it enters the body to where it
lodges).
metabolic p. The sequence of chemical reactions that occur as a substance
is metabolized.
motor p. A pathway over which motor impulses are carried from the central nervous system to muscles or
glands.
pentose phosphate p. The pathway
of glucose metabolism in tissues during
which five-carbon sugars are formed.
sensory p. A pathway over which
sensory impulses are conveyed from
sense organs or receptors to sensory or
reflex centers of the spinal cord or brain.
-pathy Combining form indicating disease.
patient (pā⬘shĕnt) [L. patiens] 1. One
who is sick with, or being treated for, an
illness or injury. 2. An individual receiving medical care. SEE: table.
p. advocate A person who ensures
that a patient is served adequately by
the health care system.
p. autonomy The right of an informed patient to choose to accept or to
refuse therapy. SEE: advance directive;
informed consent; living will; quality of
life.
p. day The basic time unit for calculating the cost of keeping a patient in a
hospital for 1 day.
p. delay Delay on the part of the patient in seeking medical attention or in
taking prescribed medicines or advice.
p. mix The numbers and types of patients served by a hospital or other
health program.
surrogate p. A normal, healthy individual who is employed to be examined and perhaps interviewed by
health-care students. The purpose is to
provide students with the opportunity
to examine an individual in a less
stressful setting than would be the case
if the person being examined were indeed sick. This also prevents persons
who are ill from being subjected to multiple examinations by students. In some
cases, the surrogate patient is an actor
who has been instructed to pretend to
be sick, injured, disabled, or hostile.
SEE: table.
Patient Advise and Consent Encounter
ABBR: PACE. An interactive computer
program to assist a patient to understand certain medical and surgical procedures and their risks. The program
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patient advocate
1723
patient education
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A Patient’s Perception of Quality Health Care
Quality Indicator
Access
Attentiveness
Availability of primary care
Availability of specialty care
Communication
Continuity
Cost
Craftsmanship
Dignity
Hygiene
Outcome
Time management
The Patient’s Viewpoint
Scheduling a visit with my health care provider
was easy and convenient.
My concerns were heard, and my needs were anticipated and addressed.
I saw someone who knows me personally.
I saw someone who is skilled in managing my specific problems.
I was able to contact my health care providers easily. We were able to talk to each other simply
and directly. I was told what to expect during
my care.
Follow-up care was easy to arrange with professionals I already know.
My care was affordable and was worth its cost.
I was carefully examined, and my treatment was
technically competent.
I was treated with respect.
The facilities where I received care were spotless.
Things turned out well. (If things did not turn out
well, problems were anticipated and explained
to me in advance.)
I was not left waiting for long. My health care providers respected my schedule.
uses touch-screen technology, animation, and an actor-doctor narrator to
communicate with the patient. At the
end of each program, the patient may
take an interactive quiz that evaluates
understanding of the presentation. A
printout of the entire session is available for the patient and the physician.
patient advocate An individual, such as
an attorney, friend, nurse, ombudsman,
physician, or social worker, who pleads
for and preserves a patient’s rights to
health care. Patient advocates address
many common and important health
care issues, including the right to access
a health care provider, the right to obtain confidential care, and the right for
the patient to work after diagnosis or
treatment.
Patient’s Bill of Rights A declaration of
the entitlements of hospital patients,
compiled by the American Hospital Association. First published in 1973, it emphasizes the responsibilities of hospitals and patients and the need for
communication and collaboration between them. The patient is entitled to
consideration and respect while receiving care; accurate, understandable information about the condition and treatment; privacy and confidentiality; an
appropriate response to the request for
treatment; and continued care as necessary after leaving the hospital. The
patient may also have an advance directive regarding treatment; designate a
surrogate to make decisions; review his
or her medical records; be informed of
hospital policies or business relationships that may affect care; and agree or
refuse to participate in treatments or research studies. Patient responsibilities
include providing any information (e.g.,
an advance directive) that may influence treatment; providing the needed
information for insurance claims; and
understanding how lifestyle affects
health. The full text of the Patient’s Bill
of Rights is available from the American
Hospital Association, One North Franklin, Chicago, IL 60606, phone number:
312-422-3000.
patient care data set ABBR: PCDS. A
terminology data set recognized by the
American Nurses Association and developed by Dr. Judith Ozbolt primarily
for use in the acute care arena. The data
set includes terms and codes for patient
problems, therapeutic goals, and patient care orders.
patient circuit The artificial conduit that
relays gases between a mechanical ventilator and a patient.
patient compensation fund A governmentally administered account used as
a treasury from which disbursements
are made to those injured as a result of
incompetence or malpractice by health
care providers.
patient concern A complaint or grievance
raised by a patient (or a personal representative of a patient) about care rendered to him or her.
patient education Health information
and instruction to help patients learn
about specific or general medical topics,
such as the need for preventive services,
the adoption of healthy lifestyles, the
correct use of medications, or the care of
diseases or injuries at home.
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1724
pause
patient management A description of
Patrick’s test (păt⬘rı̆ks) [Hugh Talbot
the interaction, from intake to discharge, between the patient and the
health care team. It includes communication, empathy, examination, evaluation, diagnosis, prognosis, and intervention. The last element, intervention (or
treatment), depends on the others.
patient outcomes research team ABBR:
PORT. Those involved in investigating
the results of disease interventions and
comparing the benefit or lack of benefit
of various therapeutic measures.
patient return electrode In electrosurgery, an electrode that collects the current used to operate on the patient and
returns it to a current generator.
Patient Self-Determination Act ABBR:
PSDA. A 1991 act of the U.S. Congress
that preserves individual rights to decisions related to personal survival.
There are several methods for preserving autonomy: filing appropriate forms
for durable power of attorney for health
care, making a living will, or giving a
directive to the physician.
patients’ rights Those culturally and legally specified rights, claims, powers,
privileges, and remedies due to a person
receiving health care services. They include, but are not limited to, the following:
1. access to care;
2. aftercare assistance or aid;
3. an appeals process when one has
a grievance;
4. choice in the selection of one’s
health care providers;
5. confidentiality and privacy;
6. freedom from discrimination;
7. information;
8. respectful treatment;
9. safety;
10. shared decision making; and
11. respect for patient preferences
and wishes.
patient transporter Someone who conveys patients from one health care location to another.
patient-ventilator interaction The complex link between a patient’s neurologically mediated control of breathing
(and the elasticity and resistance of his
or her airways) and the pressures and
volumes of gases injected into the patient by a mechanical ventilator. Failure of these two systems to work harmoniously is called patient-ventilator
dyssynchrony.
patient-year A patient experience of 1
year’s duration, e.g., on a waiting list, in
a treatment program, under observation, or suffering an illness. One patient-year is equal to, for example, the
experience of two patients for 6 months,
or 12 patients for 1 month each.
patricide (păt⬘rı̆-sı̄d) [L. patricida] Murder of one’s father or another close relative.
Patrick, U.S. neurologist, 1860– 1939]
A test for arthritis of the hip. The thigh
and knee of the supine patient are
flexed, and the external malleolus of the
ankle is placed over the patella of the
opposite leg. The test result is positive
if depression of the knee produces pain.
This test is also called the fabere test.
“FABERE” is a mnemonic for the position the hip assumes during this test:
Flexion, ABduction, External Rotation,
and Extension. SYN: FABERE maneuver.
patrilineal (păt-rĕ-lı̆n⬘ē-ăl) [L. pater, father, ⫹ linea, line] Tracing descent
through the father.
pattern (păt-tĕrn) 1. A design, figure,
model, or example. 2. In psychology, a
set or arrangement of ideas or behavior
reactions. Particular patterns are listed
under the first word. SEE: e.g., functional health pattern; synergy patterns;
wear pattern.
patterning (păt-tĕrn-ēng) A therapeutic
method used in treating children and
adults with brain damage. The patient
is guided through movements such as
creeping or crawling, based on the theory that undamaged sections of the
brain will develop the ability to perform
these functions.
pattern recognition receptor ABBR:
PRR. Any receptor on an antigen-presenting cell of the immune system that
recognizes molecular sequences found
on disease-causing organisms but not
host cells. Pattern recognition receptors
detect the presence of pathogen-associated chemicals such as lipopolysaccharides, mannans, and teichoic acids.
patulous (păt⬘ū-lŭs) [L. patulus] Patent.
pauciarticular (păw-sē-ăr-tı̆k⬘ū-lăr) A
classification of juvenile rheumatoid arthritis that indicates that four or fewer
joints are affected at the time of onset of
the disease.
Pau d’Arco (pow dăr⬘koo) [Portuguese]
The inner bark of the Tabebuia avellanedae, an evergreen tree of the rain forests of Central and South America. It is
marketed as a tea that is promoted as a
treatment for cancer, fungal diseases,
inflammation, and pain.
pause (păwz) [ME.] An interruption; a
temporary cessation of activity.
compensatory p. The long interval
following a premature ventricular contraction, so called because it does not
disturb the normal sinus pacing of the
heart.
noncompensatory p. The interval
on the electrocardiogram that follows a
premature atrial contraction (PAC). Because PACs reset the sinus pacemaker,
the next sinus beat does not appear
when it would have if there had been no
extra beat.
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1725
sinus p. An interruption in the normal pacemaking function of the sinus
(sinoatrial) node of the heart, resulting
in a decrease in the number of heartbeats per minute. When sinus pauses
are rare, the condition may be asymptomatic. When they occur frequently,
patients may note palpitations or experience loss of consciousness.
Pautrier microabscess (pō-trē-ā⬘) A local
collection of malignant lymphocytes. It
is found on microscopic examination of
biopsies taken from patients with cutaneous T cell lymphoma.
Pavlik harness (pŏv⬘lı̆k) A device used to
stabilize the hip in neonates with congenital hip dislocation.
Pavlov, Ivan Petrovich (păv⬘lŏv) Russian
physiologist, 1849– 1936; winner of Nobel Prize in medicine in 1904. He is remembered particularly for his work on
conditioning. SEE: reflex, conditioned.
pavor (pā⬘vor) [L.] Anxiety, dread.
p. diurnus Attacks of terror or fright
during the day, esp. in children.
p. nocturnus A night terror; a nightmare.
PAWP pulmonary artery wedge pressure.
Paxil, Paxil CR SEE: paroxetine.
pay for performance ABBR: PFP, or,
P4P. The use of specific indicators of
health care efficiency or quality to increase or decrease the funds paid to
health care providers for the services
they render.
Pb [L. plumbum] Symbol for the element
lead.
P.B. Pharmacopoeia Britannica, British
pharmacopeia.
PBI protein-bound iodine.
PbtO2 The partial pressure of oxygen in
brain tissue, measured with a probe
placed in the central nervous system.
P.B.W. posterior bitewing in dentistry.
PBZ pyribenzamine.
p.c. L. post cibum, after a meal.
PCG phonocardiogram.
pCi picocurie.
PCO2 Symbol for partial pressure of carbon dioxide.
PCP phencyclidine hydrochloride; Pneumocystis carinii pneumonia; primary
care physician.
PCR polymerase chain reaction; prehospital care report.
PC-SPES (pē-sē-spēs⬘) A mixture of
herbs (chrysanthemum, Ganoderma lucidum, isatis, licorice, Panax pseudoginseng, Rabdosia rubescens, saw palmetto, and scutellaria) with estrogen-like
effects. The mixture was formerly promoted as an alternative therapy for prostate cancer. It has been taken off the market in the U.S. because of contamination
and adulteration with pharmaceuticals.
PCV packed cell volume.
PCWP pulmonary capillary wedge pressure.
peau d’orange
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Pd Symbol for the element palladium.
p.d. prism diopter; pupilla diameter; pupillary distance.
PDA patent ductus arteriosus; personal
digital assistant.
PDR Physicians’ Desk Reference.
PEA phenylethylamine; pulseless electrical activity.
Peabody Developmental Motor Scales
(pē’bŏd⬙ē, pē⬘bı̆-dē⬙) ABBR: PDMS. A
standardized performance test of gross
and fine motor development for infants
and children. The PDMS is suitable for
newborns, infants, and children up to 6
years of age. Subtests include reflexes,
stationary, locomotion, object manipulation, grasping, and visual-motor manipulation.
peak and trough The highest and lowest
concentrations of a drug in plasma.
Measurement of peak and trough drug
levels are used to determine whether an
intravenously administered medication
is consistently within therapeutic
range. The trough is drawn just before
a drug is scheduled to be given; the peak
is drawn after the drug is administered
(30 to 60 min after infusion). These measurements may guide therapy in the use
of potentially toxic medications, e.g.,
aminoglycosides, which can have serious adverse effects if therapeutic levels
are exceeded or can fail to work effectively if adequate drug levels are not attained.
peanut (pē⬘nŭt⬙) An oily herb of the legume family, Arachis hypogaea, whose
seeds are consumed for their nutritional
value and whose oil, derived from the
seeds, is used in cooking.
pearl (pı̆rl) [ME. perle] 1. A small, tough
mass in the sputum in asthma. 2. A
small capsule containing a medicinal
fluid for inhalation. The capsule is
crushed in a handkerchief and inhaled.
3. A small mass of cells. 4. A concise,
memorable, and informative idea about
patient care gained from clinical experience.
enamel p. Small rounded globules of
highly mineralized material seen near
or attached to the enamel margin or furcation of the tooth roots. These are
formed by aberrant ameloblasts and hypermineralization.
epithelial p. Concentric squamous
epithelial cells in carcinoma.
gouty p. Tophus (1).
Pearl index (pŭrl) A measure of the reliability of any birth control method. A
Pearl index of 1.0 signifies that if 100
women use a particular contraceptive
method for 1 year, only one of them will
become pregnant. The most effective
contraceptive methods have Pearl indexes of about 0.7.
peau d’orange (pō⬙dō-rănj⬘) [Fr., orange
skin] Dimpling, pitting, and swelling,
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peccant
1726
seen in inflamed skin (e.g., in acne rosacea) or in the skin that overlies inflammatory carcinoma of the breast.
peccant (pĕk⬘ănt) [L. peccans, sinning]
1. Corrupt; producing disease. 2. Sinning, or violating a law.
pecilo- SEE: poikilo-.
pecten (pĕk⬘tĕn) pl. pectines [L., comb]
1. A comblike organ. 2. Pubic bone.
3. The middle portion of the anal canal.
p. pubis A sharp ridge on the superior ramus of the pubis that forms the
pubic portion of the terminal (iliopectineal) line.
pectic acid (pĕk⬘tı̆k) [Gr. pektos, congealed] An acid, C17H24O16 derived
from pectin by hydrolyzing its methyl
ester group.
pectin (pĕk⬘tı̆n) [Gr. pektos, congealed]
Water-soluble carbohydrate polymers,
found in ripe fruits, such as the apple,
grape, peach, or plum. Pectins are colloids; they form gels in solution. They
are used to make jams, jellies, and some
medications.
pectinase (pĕk⬘tı̆-nās) An enzyme that
catalyzes the formation of sugars and
galacturonic acid from pectin.
pectinate (pĕk⬘tı̆-nāt) [L. pecten, comb]
Having teeth like a comb.
pectineal (pĕk-tı̆n⬘ē-ăl) Relating to the
pubic bone or the pectineal muscle.
pectineus (pĕk-tı̆n-ē⬘ŭs) [L. pecten,
comb] A flat quadrangular muscle at
the upper and inner part of the thigh,
arising from the superior ramus of pubis
and inserted between the lesser trochanter and linea aspera of the femur,
which flexes and adducts the thigh.
pectization (pĕk-tı̄-zā⬘shŭn) [Gr. pektos,
congealed] In colloidal chemistry, the
conversion of a substance from sol to gel
state.
pector-, pectoro- Combining forms
meaning chest.
pectora (pĕk⬘tor-ă) [L.] Pl. of pectus.
pectoral (pĕk⬘tō-răl) [L. pectoralis]
1. Concerning the chest. 2. Efficacious
in relieving chest conditions, as a cough.
pectoralis (pĕk⬙tō-rā⬘lı̆s) [L.] 1. Pert. to
the chest. 2. Any of the two overlapping
muscles on each side of the anterior upper portion of the chest.
p. major A large triangular muscle
that extends from the sternum to the
humerus and functions to flex, horizontally adduct, and internally rotate the
arm, and aids in chest expansion when
the upper extremities are stabilized.
p. minor A muscle beneath the pectoralis major, attached to the coracoid
process of the scapula that depresses as
well as causes anterior tipping of the
scapula.
pectoriloquy (pĕk⬙tō-rı̆l⬘ō-kwē) [L. pectoralis, chest, ⫹ loqui, to speak] The
distinct transmission of vocal sounds
during auscultation of the chest with a
pediatrician
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stethoscope. The words seem to emanate from the spot that is auscultated.
Pectoriloquy is heard over cavities that
communicate with a bronchus and areas of consolidation near a large bronchus, over pneumothorax when the
opening in the lung is patulous, and
over some pleural effusions. SYN: pectorophony. SEE: chest.
pectorophony (pĕk⬙tō-rŏf⬘ō-nē) [⬙ ⫹
Gr. phone, voice] Pectoriloquy.
pectose (pĕk⬘tōs) [Gr. pektos, congealed]
A substance found in some fruits and
vegetables. It yields pectin when boiled.
pectus (pĕk⬘tŭs) pl. pectora [L.] The
chest.
p. carinatum Pigeon breast.
p. excavatum A congenital condition
in which the sternum is abnormally depressed. SYN: funnel breast; pectus recurvatum.
p. recurvatum Pectus excavatum.
ped- SEE: pedo-.
pedagogy (pĕd⬘ŭ-gŏj⬙ē, −gō⬙jē) [Gr. paidagogos, an assistant who takes children to school] The art, sciences, techniques, and professional methods used
in teaching, especially the teaching of
school-age children.
pedal (pĕd⬘l) [L. pedalis] Concerning
the foot.
pedal spasm Involuntary contractions of
the muscles of the feet.
pedatrophy (pē-dăt⬘rō-fē) [Gr. pais,
child, ⫹ atrophia, want of nourishment] 1. Marasmus. 2. Any wasting
disease in children. 3. Gastrointestinal
tuberculosis.
pederast (pĕd⬘ĕr-ăst) [Gr. paiderastes, a
lover of boys] A man who indulges in
anal intercourse with young boys.
pederasty (pĕd⬘ĕr-ăs⬙tē) Anal intercourse between a man and a young boy.
pedi- SEE: pedo-.
pedia- [Gr. pais, child] Combining form
denoting child.
pediatric (pē-dē-ăt⬘rı̆k) [Gr. pais, child,
⫹ iatreia, treatment] Concerning the
treatment of children.
pediatric advanced life support ABBR:
PALS. The treatment measures, including basic and advanced life support,
needed to stabilize a critically ill or injured child.
pediatric autoimmune neuropsychiatric
disorder associated with streptococci
ABBR: PANDAS. Any of the childhood
behavioral disorders (esp. tic disorders,
Tourette’s syndrome, and obsessivecompulsive disorder) that begin before
puberty and are associated with and
worsened by group A beta-hemolytic
streptococcal infections (e.g., strep
throat or scarlet fever). Researchers
suspect that an autoimmune response
to the infection is responsible for the
syndrome.
pediatrician (pē-dē-ă-trı̆sh⬘ăn) [⬙ ⫹ ia-
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pediatrics
1727
trikos, healing] A specialist in children’s diseases.
pediatrics (pē-dē-ăt⬘rı̆ks) [Gr. pais,
child, ⫹ iatreia, treatment] The care
of children and the treatment of their
diseases. SEE: mortality for table.
pediatric trauma score ABBR: PTS. A
method for scoring and quantifying the
severity of trauma in pediatric patients.
SYN: revised trauma score.
pedicel (pĕd⬘ı̆-sĕl) 1. Foot process or
footplate. 2. A secondary process of a podocyte that in conjunction with other
podocytes forms the inner layer of Bowman’s capsule of a renal corpuscle.
pedicellation (pĕd⬙ı̆-sĕl-ā⬘shŭn) [L. pediculus, a little foot; stalk] The formation and development of a pedicle.
pedicle (pĕd⬘ı̆-k’l) 1. The stem that attaches a new growth. SYN: peduncle (1).
2. The bony process that projects backward from the body of a vertebra, connecting with the lamina on each side. It
forms the root of the vertebral arch.
pedicle screw A rigid surgical implant
used to stabilize adjacent spinal segments in spinal fusion surgery. Pedicle
screws have been used to treat spinal
disorders, including those caused by spinal cancer, congenital anomalies,
trauma, and chronic pain syndromes.
Potential complications may include increased pain, infection, or mechanical
failure (breakage of the screws or the
rods that connect them).
pedicular (pē-dı̆k⬘ū-lar) [L. pediculus, a
louse] Infested with or concerning lice.
pedicular (pē-dı̆k⬘ū-lar) [L. pediculus, a
little foot] Concerning a stalk or stem.
pediculate (pē-dı̆k⬘ū-lāt) [L. pediculus, a
little foot] Pedunculate.
pediculation (pē-dı̆k⬙ū-lā⬘shŭn) [L. pediculatio] 1. Infestation with lice. 2. Development of a pedicle.
pediculicide (pē-dı̆k⬘ū-lı̆-sı̄d) [L. pediculus, a louse, ⫹ caedere, to kill] Destroying, or that which destroys, lice.
Pediculidae (pĕd’’ŭ-kūl’ı̄-dē”) A family of
lice belonging to the order Anoplura. It
includes the species parasitic on primates, including humans. SEE: Pediculus.
pediculosis (pē-dı̆k⬙ū-lō⬘sı̆s) [⬙ ⫹ Gr.
osis, condition] Infestation with lice.
SEE: Pediculus.
p. capitis A scalp infection caused by
head lice, Pediculus humanus capitis, a
common parasite in children. Outbreaks are common in schools, esp.
among children between the ages of 5
and 11. The infection is transmitted
through use of personal items such as
hair ornaments, combs, hairbrushes,
hats, scarves, or coats or through direct
contact between the heads of two children. Lice, which feed on blood obtained
by biting the skin, cause itching, esp.
around the ears, in the occipital area,
and at the nape of the neck. Long-stand-
pediculosis
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ing infestations may produce chronic inflammation. The adult louse is seen
rarely; diagnosis usually is made
through the presence of eggs (nits),
which appear as whitish sacs attached
to the hair. SEE: illus.
PEDICULOSIS CAPITIS
SYMPTOMS: Itching and eczematous
dermatitis. In long-standing, neglected
cases, scratching may result in marked
inflammation. Secondary infection by
bacteria may occur, with formation of
pustules, crusts, and suppuration. Hair
may become matted and malodorous.
TREATMENT: Therapies for lice infestations are modified frequently, to
match the resistance of lice to current
therapies and to minimize the toxicities
of medications. Manual removal of lice
always is appropriate and is strongly
recommended by lice specialists. Others
recommend the use of insecticides (pediculocides).
PATIENT CARE: The patient and
family are taught how to apply medication (lindane, permethrin, pyrethrins,
piperonyl butoxide, malathion) to dry
hair for lice and are warned that the
eyes should be immediately flushed
with copious amounts of water if the
medication accidentally contacts them.
They are informed about minimizing
the spread of infection by washing or
dry cleaning all clothing and linen used
in the home, delousing of rugs and upholstered furniture with sprays or vacuuming, keeping combs and brushes separate, and using medicinal shampoos if
there has been contact with the patient.
p. corporis Pediculosis caused by the
body louse, Pediculus humanus. It is
transmitted by direct contact or by
wearing infested clothing and is often
transmitted in crowded or unhygienic
conditions. The body louse occasionally
is the vector for several important
transmissible illnesses, including epidemic typhus, trench fever, and relapsing fever.
SYMPTOMS: Infestation with body
lice is marked by intense itching, esp. on
the neck, trunk, and thighs. Tiny hemorrhagic points identify the bites. Generalized excoriation, mild fever, and fa-
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1728
tigue characterize heavy infestations.
In severe cases, pustules may develop.
The patient first
TREATMENT:
bathes with hot soap and water and
then applies prescribed creams containing approved pesticides to affected areas.
PATIENT CARE: The patient should
be assessed for diseases that body lice
may transmit. If the patient is homeless
or impoverished, social services agencies should be contacted to assist him or
her to find shelter and clean clothing. If
the patient lives with others, close personal contacts or family members
should be screened for lice. All clothing,
furniture, rugs, and bedding must be
washed with hot water or dry cleaned.
To prevent transmission of pediculosis
among hospitalized patients, all highrisk patients should be examined for evidence of hair or body lice infestation on
admission. Health care professionals
should be careful to include older adults
who are dependent on others for care,
those coming from nursing homes or
other assisted living facilities, and people living in crowded conditions.
p. palpebrarum Infestation by lice of
the eyebrows and eyelashes.
p. pubis Pediculosis caused by Phthirus pubis, also known as crab lice. It is
transmitted by direct contact and
through bedding or shared towels. The
pubic louse can also infest the axillae,
eyelashes, and head hair. The patient
can present with pruritus. On occasion
visual identification of the lice may be
seen in pubic hair as oval attachments
on pubic hair shafts, black dots (feces)
on skin and underwear, or crusts or
scabs in pubic area from scratching.
Treatment is the same as for other ectoparasitic (skin parasite) infestations.
pediculous (pĕ-dı̆k⬘ū-lŭs) Infested with
lice.
Pediculus (pē-dı̆k⬘ū-lŭs) A genus of parasitic insects, commonly called lice, that
infest humans and other primates. Lice
are sucking insects belonging to the
family Pediculidae, order Anoplura.
They transmit the causative organisms
of epidemic typhus, trench fever, and relapsing fever to animal hosts.
P. humanus capitis The head louse
that lives in the fine hair of the head,
including the beard and eyebrows. Its
eggs, commonly called nits, may be
found glued to hairs. They form nests in
the vicinity of the ears. This organism
is the cause of pediculosis capitis.
P. humanus corporis The body louse
that inhabits the seams of clothing worn
next to the body and feeds on regions of
the body covered by that clothing. Eggs
are attached to fibers of the clothing.
This organism causes human illnesses
including pediculosis corporis and
trench fever.
peduncle
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pediculus (pē-dı̆k⬘ū-lŭs) pl. pediculi [L.]
1. A little foot. 2. Louse. SEE: Pediculus.
pedicure (pĕd⬘ı̆-kūr) [L. pes, foot, ⫹
cura, care] 1. Care of the feet. 2. Cosmetic care of the feet and toenails. 3. Podiatrist.
pediform (pĕd⬘ı̆-form) [⬙ ⫹ forma,
shape] Having the shape of a foot.
pedigree (pĕ-dı̆-grē) A chart, diagram, or
table of an individual’s ancestors used
in genetics to analyze or reveal inherited traits and illnesses.
pedo-, pedi-, ped- [L. pes, foot] Combining form meaning foot.
pedodontia,
pedodontics
(pē⬙dōdŏn⬘shē-ă, −tı̆ks) [Gr. pais, child, ⫹
odous, tooth] The branch of dentistry
that includes training the child to accept dentistry; restoring and maintaining the primary, mixed, and permanent
dentitions; applying preventive measures for dental caries and periodontal
disease; and preventing, intercepting,
and correcting various problems of occlusion.
pedodontist (pē⬙dō-dŏn⬘tı̆st) A dentist
who specializes in care of children’s
teeth.
pedodynamometer (pĕd⬙ō-dı̄-nă-mŏm⬘ĕtĕr) [L. pes, foot, ⫹ Gr. dynamis,
power, ⫹ metron, measure] A device
for measuring the strength of the leg
muscles.
pedograph (pĕd⬘ō-grăf) [⬙ ⫹ Gr. graphein, to write] An imprint of the foot on
paper.
pedometer (pĕd-ŏm⬘ĕ-tĕr) [L. pes, foot,
⫹ Gr. metron, measurement] An instrument that indicates the number of
steps taken while walking.
pedomorphism (pē⬙dō-mor⬘fı̆zm) [Gr.
pais, child, ⫹ morphe, form, ⫹ −ismos, condition] The retention of juvenile characteristics in the adult.
pedophilia (pē⬙dō-fı̆l⬘ē-ă) [⬙ ⫹ philein,
to love] An unnatural desire for sexual
relations with children.
pedorthics (pēd⬘ŏr-thı̆ks) [L. pes, foot ⫹
Gr. orthos, straight] The making and
fitting of shoes and other foot support
products to alleviate and prevent foot
injury and disease.
pedorthist (pēd⬘ŏr-thı̆st) A footwear specialist. Pedorthists design and produce
individually fitted shoes and foot support products to alleviate and prevent
foot injury and disease.
peduncle (pĕ-dŭn⬘kl) [L. pedunculus, a
little foot] 1. Pedicle (1). 2. A brachium
of the brain; a band connecting parts of
the brain. SEE: crus; sessile.
cerebral p. A pair of white bundles
from the upper part of the pons to the
cerebrum. It constitutes the ventral portion of the midbrain. SYN: crus cerebri.
inferior cerebellar p. A band of fibers
running along the lateral border of the
fourth ventricle, connecting the spinal
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peduncle
1729
cord and medulla with the cerebellum.
SYN: restiform body.
middle cerebellar p. A band of fibers
connecting the cerebellum with the basilar portion of the pons. SYN: brachium
pontis.
pineal p. A band from either side of
the pineal gland to the anterior pillars
of the fornix at the back of the roof of
the third ventricle. The pineal recess is
a space nestled into the peduncle. SYN:
pineal stalk.
superior cerebellar p. A band of fibers connecting the cerebellum with the
midbrain. SYN: brachium conjunctivum.
p. of superior olive A slender band of
fibers extending from the superior olivary nucleus in the medulla to the nucleus of the abducens nerve.
thalamic p. One of four groups of fibers known as thalamic radiations that
connect the thalamus with the cerebral
cortex. SEE: radiation, thalamic.
peduncular (pĕ-dŭn⬘kū-lăr) [L. pedunculus, a little foot] Concerning a peduncle.
pedunculate, pedunculated (pĕ-dŭn⬘kūlāt, −ĕd) Possessing a stalk or peduncle.
SYN: pediculate.
pedunculotomy
(pĕ-dŭng⬙kū-lŏt⬘ō-mē)
[⬙ ⫹ Gr. tome, incision] Surgical section of a cerebral peduncle. It has been
used to treat involuntary movement disorders.
peeling (pē-lēng) [ME. pelen, to peel]
Shedding of the surface of the skin.
SEE: desquamation.
chemical p. Agents applied to skin to
produce a mild, superficial burn; done to
remove wrinkles.
PEEP (pēp) positive end-expiratory pressure.
PEEP decrement (trial) Sequential decreases in positive end-expiratory pressures (PEEP) until the lowest level of
PEEP is achieved that improves lung
compliance the most, without reducing
the patient’s partial pressure of oxygen.
PEEP is then adjusted to a value just
higher than that value.
peer (pēr) [ME.] One who has an equal
standing with another in age, class, or
rank.
p. review The evaluation of the quality of the work effort of an individual by
his or her peers. It could involve evaluation of articles submitted for publication or the quality of medical care administered by an individual, group, or
hospital.
PEG (pĕg) percutaneous endoscopic gastrostomy.
peg, rete (pĕg) Rete ridge.
Peganum harmala (pĕ-gahn⬘ ŭm hahr⬘
mŭ-lŭ) A weed, commonly known as
Syrian rue and considered a livestock
toxin, used for medicinal and spiritual
purposes in many regions of the world.
peliosis
Extracts (tea) made from its seeds are
consumed ceremonially in certain cultures. They contain beta-carboline alkaloids, a class of chemicals that increase levels of serotonin in the brain.
Use of the extracts may induce hallucinations. Overdose may result in the serotonin syndrome.
peg tooth An abnormally shaped tooth of
genetic origin. Usually noted as a maxillary lateral incisor with a smaller
cone-shaped crown.
pegylation (pĕg⬘ı̆-lā⬘-shŭn) The chemical linking of a drug (e.g., interferon) to
polyethylene glycol. Pegylation increases the half-life of interferon.
PEJ (pĕj) percutaneous endoscopic jejunostomy.
pejorative (pı̆-jawr⬘ă-tı̆v, pē⬙jă-rā⬘tı̆v) [L.
pejor, worse] 1. Tending to become or
make worse. 2. Disparaging or belittling.
PEL permissible exposure limits.
pelade (pĕl-ăd⬘) [Fr., to remove hair] Alopecia areata.
pelage (pĕl⬘ı̆j) [Fr.] The collective hair
of the body.
Pel-Ebstein fever (pĕl⬘ĕb⬘stı̄n) [Pieter K.
Pel, Dutch physician, 1852– 1919; Wilhelm Ebstein, Ger. physician, 1836–
1912] Cyclic fever occurring in Hodgkin’s disease in which high body temperatures lasting from 3 to 10 days are
separated by an afebrile period of about
the same length.
Pelger-Huët anomaly (pĕl⬙jĕr hū⬘ĕt)
[Karel Pelger, Dutch physician, 1885–
1931; Gauthier Jean Huët, Dutch physician, 1879– 1970] ABBR: PHA. A benign autosomal dominant disorder of
neutrophil maturation, in which granulocytes form with rodlike, dumbbell,
peanut-shaped, and spectacle-like nuclei. The chromatin of the nuclei is unusually coarse. Despite their unusual
shape, the oddly formed cells function
normally. An anomaly in white blood
cell formation called Pseudo-PHA or acquired PHA appears structurally similar to PHA and occurs in myelodysplasia and some leukemias.
peliosis (pē-lē-ō⬘sı̆s) [Gr.] Purpura.
bacillary p. A complication of an infection due to Bartonella henselae and
B. quintana, esp. in immunocompromised patients. The infection causes
vascular lesions in the visceral organs,
esp. the liver and spleen.
p. hepatis Multiple cystic, bloodfilled spaces in the liver associated with
dilatation of the sinusoids. These cause
enlargement of and pain in the liver.
These lesions are associated with use of
oral contraceptives, certain types of anabolic steroids, and infections with Bartonella organisms. If the condition is
due to infection, treatment consists of
parenteral doxycycline for several
weeks followed by several months of
top of rh
base of rh
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Pelizaeus-Merzbacher disease
pelvic inflammatory disease
top of rh
base of rh
small round object, such as a bit of buckshot or a BB, that may enter the body
in gunshot injuries.
cotton p. A small rolled cottonball,
less than 3⁄8 in (about 1 cm) in diameter,
used for desiccation or topical application of medicaments, particularly in
dentistry; also called pledgets.
foil p. Loosely rolled gold foil used for
direct filling in dental restoration. SEE:
foil.
pellicle (pĕl⬘ı̆-k’l) [L. pellicula, a little
skin] 1. A thin piece of cuticle or skin.
2. Film or surface on a liquid. 3. Scum.
salivary p. The thin layer of salivary
proteins and glycoproteins that quickly
adhere to the tooth surface after the
tooth has been cleaned; this amorphous,
bacteria-free layer may serve as an attachment medium for bacteria, which in
turn form plaque.
pellitory-of-the-wall (pĕl⬘ı̆-tŏr⬙ē ŭv thŭwăl) [L. pellitorium, feverfew] Parietaria judaica.
pellucid (pĕl-lū⬘sı̆d) [L. pellucidus]
Clear.
pellucid zone Zona pellucida.
pelotherapy (pĕ⬙lō-thĕr⬘ă-pē) [Gr. pelos,
mud, ⫹ therapeia, treatment] The
therapeutic use of mud, peat, moss, or
clay applied to all or part of the body.
pelv-, pelvi-, pelvo- Combining forms
meaning pelvis.
pelvic (pĕl⬘vı̆k) [L. pelvis, basin] Pert. to
a pelvis, usually the bony pelvis.
pelvicephalometry (pĕl⬙vē-sĕf⬙ă-lŏm⬘ĕtrē) [⬙ ⫹ ⬙ ⫹ metron, measure]
Measurement of the diameters of the fetal head and comparison of these with
the diameters of the maternal pelvis.
pelvic floor dyssynergy Uncoordinated
or faulty contraction of the muscles that
aid defecation. It is an infrequent cause
of chronic constipation.
pelvic inflammatory disease ABBR: PID.
Infection of the uterus, fallopian tubes,
and adjacent pelvic structures that is
not associated with surgery or pregnancy. PID usually is caused by an ascending infection in which disease-producing germs spread from the vagina
and cervix to the upper portions of the
female reproductive tract. SEE: chlamydia; gonorrhea; Nursing Diagnoses
Appendix.
ETIOLOGY: Chlamydia trachomatis
and Neisseria gonorrhoeae are the most
frequent causes of PID, although anaerobic microorganisms, Escherichia coli,
and other microorganisms also are often
involved.
The most common
SYMPTOMS:
symptom is lower abdominal or pelvic
pain, typically beginning after the start
of a menstrual period. Exquisite tenderness during physical examination of the
cervix, fallopian tubes, or ovaries is a
common sign. Clear, white, or purulent
vaginal discharge is sometimes present.
short
standard
1730
oral therapy. SEE: bacillary angiomatosis; cat scratch disease.
Pelizaeus-Merzbacher disease (pĕl-ı̆-zā⬘
ŭs-mŭrts⬘ bŏk-ĕr, −mă rts⬘) [F. Pelizaeus, Ger. neurologist, 1850– 1917; L.
Merzbacher, Ger. neurologist, 1875–
1942] An X-linked disorder of myelin
formation marked by cognitive deficits,
nystagmus, spasticity, and gait disturbance.
pellagra (pĕl-ă⬘gră, pĕ-lăg⬘ră) [L. pellis,
skin, ⫹ Gr. agra, rough] The clinical
consequences of profound niacin deficiency characterized by cutaneous, gastrointestinal, mucosal, and neurological
symptoms. It is found in regions of the
world where malnutrition is endemic.
SYMPTOMS: In advanced cases, stomatitis and glossitis, diarrhea, dermatitis, and central nervous system involvement occur. Cutaneous lesions
include erythema followed by vesiculation, crusting, and desquamation. The
skin may become dry, scaly, and
atrophic. The mucous membranes of the
mouth, esophagus, and vagina may atrophy; ulcers and cysts may develop.
Anemia is common. Nausea, vomiting,
and diarrhea occur, the last being characteristic. Involvement of the central
nervous system is first manifested by
neurasthenia, followed by organic psychosis characterized by disorientation,
memory impairment, and confusion.
Later, delirium and clouding of consciousness may occur.
ETIOLOGY: This condition is due to
inadequate intake or absorption of niacin (nicotinic acid) or its amide (niacinamide, nicotinamide). It is commonly
associated with restricted or limited diets in which a single cereal grain, esp.
corn, is consumed without adequate
consumption of wheat, eggs, beef, poultry, or other niacin- or tryptophan-rich
foods. The condition is often found in
chronic alcoholism.
TREATMENT: The disease is treated
by following a diet adequate in all vitamins, minerals, and amino acids supplemented by 500 to 1000 mg of niacinamide given orally three times daily. If
there is any doubt about the ability of
the intestinal tract to absorb vitamins,
the vitamins should be given parenterally.
pellagrin (pĕ-lā⬘grı̆n, −lăg⬘rı̆n) A person
afflicted with pellagra.
Pellegrini’s disease, Pellegrini-Stieda disease
(pĕl⬙ı̆-grē⬘nēz,
pĕl⬙ı̆-grē⬘nēshtē⬘dă) [Augusto Pellegrini, It. surgeon, 1877– 1958; Alfred Stieda, Ger.
surgeon, 1869– 1945] Posttraumatic
ossification of the superior portion of the
medial collateral ligament of the knee.
pellet (pĕl⬘ĕt) [Fr. pelote, a ball] 1. A
tiny pill or small ball of medicine or
food. 2. A solid that condenses at the
bottom of a centrifuged solution. 3. Any
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pelvic pain, chronic idiopathic
1731
Fevers, chills, nausea, vomiting, vaginal
bleeding, dysuria, dyspareunia, or anorectal pain are seen in smaller numbers
of patients.
Distinguishing PID
DIAGNOSIS:
from other causes of lower abdominal or
pelvic pain can be difficult. The disease
may be confused with appendicitis, diverticulitis, tubo-ovarian abscess, endometritis, ectopic pregnancy, and
other serious illnesses. PID is most
likely to be found in young, sexually active patients with multiple sexual partners, esp. if there is a history of previous
sexually transmitted illnesses or of substance abuse. Leukocytosis and an elevated sedimentation rate are commonly
found, and a mucopurulent discharge is
often present on pelvic examination.
Cultures from the vagina or cervix may
be helpful in identifying the causative
organism. In patients for whom the diagnosis is unclear, laparoscopy, ultrasonography, or computed tomography
may be needed.
COMPLICATIONS: PID may result in
adhesions or scarring of the fallopian
tubes and pelvis, and is a common cause
of pelvic pain and ectopic pregnancy.
About a third of all women who are infertile have lost the ability to conceive
because of PID. Occasionally, PID
causes intraperitoneal abscesses.
TREATMENT: Antibiotics effective
against gonococci, chlamydiae, anaerobes, and gram-negative rods usually
are used to treat PID. Typical therapy
includes a tetracycline derivative, like
doxycycline, and a cephalosporin. Early
therapy prevents infertility caused by
fallopian tube adhesions or scarring. In
patients with tubal or pelvic abscesses,
drainage is required. Sexual partners
should be examined for evidence of sexually transmitted diseases and treated
if culture results are positive. SEE: safe
sex.
pelvic pain, chronic idiopathic ABBR:
CIPP. Unexplained pelvic pain in a
woman that has lasted 6 months or
longer. A complete medical, social, and
sexual history must be obtained. In an
experimental study, women with this
illness reported more sexual partners,
significantly more spontaneous abortions, and previous nongynecological
surgery. These women were more likely
to have experienced previous significant
psychosexual trauma.
TREATMENT: The pain associated
with CIPP should be treated symptomatically and sympathetically. The participation of pain management specialists, complementary medical providers,
and the primary health care provider
should be integrated. Realistic goals
(e.g., the reduction of pain rather than
its elimination) should be set. Medroxyprogesterone acetate, oral contracep-
pelvis
tives, presacral neurectomy, hypnosis,
and hysterectomy have been tried with
varying degrees of success.
pelvic rock An exercise to strengthen the
abdominal muscles and reduce the risk
of backache or back stiffness (e.g., during pregnancy). The patient kneels on
her hands and knees, hollows her back
and pushes out her abdomen while inhaling, and arches her back like a cat
and contracts the abdominal, gluteal,
and levator muscles while exhaling. The
exercise can be done while standing
with the hands on the knees. The effects
are maximized by concurrent abdominal breathing. SEE: pelvic tilt.
pelvic tilt An exercise to strengthen the
abdominal muscles and reduce the risk
of backache or back stiffness (e.g., during pregnancy). The patient assumes a
supine position and flattens the hollow
of her back against the floor. The abdominal, gluteal, and levator muscles
are contracted with each exhalation and
relaxed with each inhalation. The effects are maximized by concurrent abdominal breathing. SEE: pelvic rock.
pelvimeter (pĕl-vı̆m⬘ĕ-tĕr) [⬙ ⫹ Gr.
metron, measure] A device for measuring the pelvis.
pelvimetry (pĕl-vı̆m⬘ĕ-trē) Measurement of the pelvic dimensions or proportions, a technique which was formerly thought to be useful in obstetrics.
pelvioplasty (pĕl⬘vē-ō-plăs⬙tē) [⬙ ⫹ Gr.
plassein, to form] 1. Enlargement of
the pelvic outlet to facilitate childbirth.
SYN: pelviotomy (1); pubiotomy; symphysiotomy. 2. Plastic surgical procedure on the pelvis of the kidney.
pelvioscopy (pĕl⬙vē-ŏs⬘kō-pē) [L. pelvis,
basin, ⫹ Gr. skopein, to examine] Inspection of the pelvis.
pelviotomy (pĕl-vē-ŏt⬘ō-mē) [⬙ ⫹ Gr.
tome, incision] 1. Enlargement of the
pelvic outlet to facilitate childbirth.
2. Incision of the renal pelvis; usually
done in order to remove a calculus.
pelvis (pĕl⬘vı̆s) pl. pelves [L., basin]
1. Any basin-shaped structure or cavity.
2. The bony compartment comprising
the innominate bones, the sacrum, and
the coccyx, joined at the symphysis pubis, sacroiliac, and sacrococcygeal articulations by a network of cartilage and
ligaments. The structure supports the
vertebral column and articulates with
the lower limbs. SEE: illus. 3. The cavity encompassed by the innominate
bones, the sacrum, and the coccyx.
ANATOMY: The pelvis is separated
into a false or superior pelvis and a true
or inferior pelvis by the iliopectineal
line and the upper margin of the symphysis pubis. The circumference of this
area constitutes the inlet of the true pelvis. The lower border of the true pelvis,
termed the outlet, is formed by the coccyx, the protuberances of the ischia, the
top of rh
base of rh
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pelvis
1732
pelvis
top of rh
base of rh
ameter of the conjugate. Transverse:
The distance between the ischial tuberosities, 11 cm (41⁄4 in.). Anteroposterior
(of outlet): The distance between the
lower border of the symphysis pubis and
the tip of the sacrum, 11 cm (41⁄4 in.).
Anterior sagittal: The distance from the
undersurface of the symphysis pubis to
the center of the line between the ischial
tuberosities, 7 cm (23⁄4 in.). Posterior
sagittal: The distance from the center of
line between the ischial tuberosities to
the tip of the sacrum, 10 cm (4 in.).
android p. The normal shape of the
male pelvis. About 30% of women share
this bony configuration; however, the
heart-shaped inlet, convergent sidewalls, slanted sacrum, and narrow sacrosciatic notch pose problems for childbearing. The narrowed dimensions
increase the risk of fetopelvic disproportion, obstructed labor, and cesarean delivery. SYN: masculine pelvis.
anthropoid p. A structural abnormality that occurs in about 20% of
women. Deviations from the normal gynecoid configuration include a long,
oval, narrow inlet and narrow sacrum,
straight sidewalls, and a wide sacrosciatic notch. The shape increases the
potential for fetal posterior positions
during childbearing.
assimilation p. A structural abnormality that results from a developmental lumbosacral fusion or from a sacrococcygeal fusion.
beaked p. A pelvis with the pelvic
bones laterally compressed and pushed
short
standard
PELVIS
ascending rami of the ischia, and the descending rami of the ossa pubis and the
sacrosciatic ligaments. The floor of the
pelvis is formed by the perineal fascia,
the levator ani, and the coccygeus muscles. All diameters normally are larger
in the female than in the male.
EXTERNAL DIAMETERS: Interspinous: The distance between the outer
edges of the anterosuperior iliac spines,
the diameter normally measuring 26 cm
(101⁄4 in.). Intercristal: The distance between the outer edges of the most prominent portion of the iliac crests, the diameter normally being 28 cm (11 in.).
Intertrochanteric: The distance between
the most prominent points of the femoral trochanters, 32 cm (121⁄2 in.). Oblique
(right and left): The distance from one
posterosuperior iliac spine to the opposite anterosuperior iliac spine, 22 cm
(81⁄2 in.), the right being slightly greater
than the left. External conjugate: The
distance from the undersurface of the
spinous process of the last lumbar vertebra to the upper margin of the anterior surface of the symphysis pubis, 20
cm (77⁄8 in.).
INTERNAL DIAMETERS: True conjugate: The anteroposterior diameter of
the pelvic inlet, 11 cm (41⁄4 in.), the most
important single diameter of the pelvis.
Diagonal conjugate: The distance between the promontory of the sacrum to
the undersurface of the symphysis pubis, 13 cm (51⁄8 in.). Two cm (3⁄4 in.) are
deducted for the height and inclination
of the symphysis pubis to obtain the di-
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pelvis
1733
forward so that the outlet is narrow and
long. SYN: rostrate pelvis; triradiate pelvis.
bony pelvis The skeleton of the pelvis, consisting of the right and left hip
bones (each made of an ilium, an ischium, and a pubis), the sacrum, and
the coccyx.
brachypellic p. An oval pelvis in
which the transverse diameter is at
least 1 cm longer, but no more than 3
cm longer, than the anteroposterior diameter of the pelvis.
brim of the p. Brim (2).
contracted p. A pelvis in which one
or more of the principal diameters is reduced to a degree that parturition is impeded.
cordate p. A pelvis possessing a
heart-shaped inlet.
coxalgic p. A pelvis deformed subsequent to hip joint disease.
dolichopellic p. An abnormal pelvis
in which the anteroposterior diameter is
greater than the transverse diameter.
dwarf p. An unusually small pelvis
in which all diameters are symmetrically reduced.
elastic p. Osteomalacic p.
extrarenal p. A renal pelvis located
outside the kidney.
false p. The portion of the pelvic cavity that lies above the pelvic brim,
bounded by the linea terminalis and the
iliac fossae. It supports the weight of the
growing uterus during the middle and
last trimesters of pregnancy. SYN: pelvis major.
fissured p. A structural malformation in which the ilia are pushed forward to an almost parallel position;
caused by rickets.
flat p. A pelvis in which the anteroposterior diameters are shortened.
frozen p. Adhesion of the female reproductive organs to the peritoneum or
bowel by cancer, endometriosis, or pelvic infection.
funnel-shaped p. A pelvis in which
the outlet is considerably contracted but
the inlet dimensions are normal.
gynecoid p. A normal female pelvis.
Relative to the male pelvis it has a
wider bone structure and a more oval
shape.
halisteretic p. A deformed pelvis resulting from softening of bones.
infantile p. An adult pelvis that retains its infantile characteristics. SYN:
juvenile pelvis.
p. justo major An unusually large
pelvis.
juvenile p. Infantile p.
kyphoscoliotic p. A deformed pelvis
caused by rickets.
kyphotic p. A deformed pelvis characterized by an increase of the conjugate
diameter at the brim with reduction of
the transverse diameter at the outlet.
pemphigoid
top of rh
base of rh
lordotic p. A deformed pelvis in
which the spinal column has an anterior
curvature in the lumbar region.
p. major False p.
masculine p. A female pelvis that resembles a male pelvis, esp. in that it is
narrower, more conical, and heavierboned and has a heart-shaped inlet.
SYN: android pelvis.
p. minor An unusually small pelvis.
p. obtecta A deformed pelvis in
which the vertebral column extends
across the pelvic inlet.
osteomalacic p. A pelvis distorted
because of osteomalacia. SYN: elastic
pelvis.
Otto p. SEE: Otto pelvis.
platypellic p. A rare structural malformation that resembles a flattened gynecoid pelvis with shortened anteroposterior and wide transverse diameters.
pseudo-osteomalacic p. A rachitic
pelvis similar to that of a person with
osteomalacia.
rachitic p. A pelvis deformed from
rickets.
renal p. The expanded proximal end
of the ureter. It is within the renal sinus
of the kidney and receives the urine
through the major calyces.
reniform p. A pelvis shaped like a
kidney.
rostrate p. Beaked p.
round p. A pelvis with a circular inlet.
scoliotic p. A deformed pelvis resulting from spinal curvature.
simple flat p. A pelvis with a shortened anteroposterior diameter.
p. spinosa A rachitic pelvis with a
pointed pubic crest.
split p. A pelvis with a congenital division at the symphysis pubis.
spondylolisthetic p. A pelvis in
which the last lumbar vertebra is dislocated in front of the sacrum, causing
occlusion of the brim.
triradiate p. Beaked p.
true p. The portion of the pelvis lying
below the iliopectineal line. The dimensions of the true pelvis are of obstetrical
significance in determining the success
of fetal descent.
pelviscopy (pĕl-vı̆s⬘ kŭ-pē) Visual examination of the female reproductive organs with a laparoscope.
pelvitherm (pĕl⬘vı̄-thĕrm) [L. pelvis, basin, ⫹ Gr. therme, heat] A device for
applying heat to the pelvis through the
vagina.
pemphigoid (pĕm⬘fı̆-goyd) [Gr. pemphigodes, breaking out in blisters] A skin
condition similar to pemphigus.
bullous p. A blistering disease found
almost exclusively in the elderly. Large,
tense bullae filled with clear serum form
on normal and urticarial skin. Lesions
predominate in the flexural aspects of
the limbs and abdomen. This condition
short
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pemphigus
penicillin
top of rh
base of rh
geal shaft and widening of its base proximal to the joint space.
Pender, Nola J. (pĕn⬘ dĕr) A U.S. nursing educator and researcher, born 1941,
who developed and refined the Health
Promotion Model nursing theory. SEE:
Health Promotion Model.
pendular (pĕn⬘dū-lĕr) [L. pendulus]
Hanging so as to swing by an attached
part; oscillating like a pendulum.
pendulous (pĕn⬘dū-lŭs) Swinging freely
like a pendulum; hanging.
penectomy (pĕn-ĕk⬘tŏ-mē) Surgical or
traumatic removal of the penis.
penetrance (pĕn⬘ĕ-trăns) 1. The frequency of manifestation of a hereditary
condition in individuals. In theory, if the
genotype is present, penetrance should
be 100%. That is not usually the case, as
a result of the modifying effects of other
genes. 2. The extent to which something
enters an object.
penetrate (pĕn⬘ĕ-trāt) [L. penetrare] To
enter or force into the interior; pierce.
penetrating (pĕn⬘ĕ-trāt-ı̆ng) Entering
beyond the exterior.
p. power The capacity of a lens to see
into an object.
penetration (pĕn⬙ĕ-trā⬘shŭn) [L. penetrare, to go within] 1. The process of entering within a part. 2. The capacity to
enter within a part. 3. The power of a
lens to give a clear focus at varying
depths. 4. The ability of radiation to
pass through a substance.
penetrometer (pĕn⬙ĕ-trŏm⬘ĕ-tĕr) [⬙ ⫹
Gr. metron, measure] An instrument
that compares roughly the comparative
absorption of x-rays in various metals,
esp. silver, lead, and aluminum; hence,
it gives a rough estimation of the ability
of x-rays to penetrate tissues. SYN:
qualimeter.
-penia (pē⬘nē-ă) [Gr. penia, lack] Combining form indicating decrease, deficiency.
penicillin (pĕn-ı̆-sı̆l⬘ı̆n) Any of a group of
antibiotics biosynthesized by several
species of molds, esp. Penicillium notatum and P. chrysogenum. Penicillin is
bactericidal, inhibiting the growth of
some gram-positive bacteria and some
spirochetes by interfering with cell wall
synthesis. There are many different
penicillins, including synthetic ones,
and their effectiveness varies for different organisms. SEE: penicillin allergy.
beta-lactamase resistant p. Synthetic penicillins that resist the action
of the enzyme beta-lactamase, produced
by some microorganisms. Bacteria that
produce the enzyme are not susceptible
to the action of non– beta-lactamase resistant penicillins.
p. G benzathine An antibiotic of the
penicillin class available in a variety of
dosage forms, used orally and parenterally.
penicillinase-resistant p. Any of a
short
standard
1734
is treated with corticosteroids and immunosuppressive agents, such as azathioprine or cyclophosphamide.
pemphigus (pĕm⬘fı̆-gŭs ) [Gr. pemphix,
a blister] An acute or chronic autoimmune disease principally of adults but
sometimes found in children, characterized by occurrence of successive crops of
bullae that appear suddenly on apparently normal skin and disappear, leaving pigmented spots. Antibodies form
against cellular adhesion molecules in
the epidermis, causing layers of the skin
to separate (and blister). A characteristic sign is a positive Nikolsky’s sign:
when pressure is applied to an area as
if trying to push the skin parallel to the
surface, the skin will detach from the
lower layers.
erythematous p. Scaling, erythematous macules and blebs of the scalp,
face, and trunk. The lesions have a “butterfly” distribution over the face. The
disease resembles pemphigus foliaceus.
p. foliaceus Pemphigus in which keratinocyte adhesion is disrupted beneath the stratum corneum. Once lesions develop, they may spread to the
entire body and mimic generalized exfoliative dermatitis. The positive Nikolsky’s sign helps to make the correct diagnosis. The condition is treated with
systemic corticosteroids.
p. vegetans A form of pemphigus
vulgaris characterized by pustules instead of bullae. Pustules are followed by
warty vegetations. Prognosis is good,
even before therapy with corticosteroids.
p. vulgaris The most common form
of pemphigus. Blisters develop suddenly and are round or oval, thinwalled, tense, and translucent and bilateral in distribution. The lesions have
little tendency to heal, and bleed easily
when they burst. Since the introduction
of corticosteroids, the prognosis for this
autoimmune disease is favorable, but
the mortality rate is still 5% to 15%. Immunosuppressive agents (e.g., azathioprine or cyclophosphamide) are used
with corticosteroid therapy. SEE: photochemotherapy.
penalization (pēn⬙ı̆l-ı̆-zā⬘shı̆n, pĕn⬙) An
ophthalmological treatment for an eye
with weak vision in which the vision
from the healthier eye is blunted,
blurred, or blocked so that the weaker
eye must be relied upon. It is one form
of treatment for amblyopia.
pencil (pĕn-sı̆l) A material rolled into cylindrical form; may contain a caustic
substance or a therapeutic paste or ointment.
pencil-in-cup deformity A form of bone
destruction (osteolysis) found in severe
inflammatory arthritis, esp. in the finger and toe joints. The deformity is
characterized by thinning of the phalan-
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group of penicillins that are not inactivated by the enzyme penicillinase.
These penicillins retain their effectiveness as antibiotics used for infections
caused by bacteria that produce penicillinase. SEE: bacterial resistance; betalactamase resistance; Staphylococcus
aureus, methicillin-resistant.
p. V potassium An antibiotic of the
penicillin class. It is relatively stable in
an acid medium and is therefore not inactivated by gastric acid when taken
orally.
penicillin allergy A hypersensitivity reaction to penicillin, present in about
0.5% to 8% of the population. Although
different types of hypersensitivity reactions may occur, the most common and
potentially dangerous are the type I (immediate) reactions mediated by immunoglobulin E. If a patient reports a history of signs of local anaphylaxis (e.g.,
urticaria) or systemic anaphylaxis (e.g.,
bronchoconstriction, vasodilation) after
taking penicillin, no penicillin or other
beta-lactam antibiotics (e.g., cephalosporins) should be given to that patient
ever again. In those very rare situations
in which an infection is susceptible to no
other antibiotic and the infection is serious enough to risk the danger of anaphylaxis, the patient may be desensitized with gradually increasing doses of
penicillin.
penicillinase (pĕn-ı̆-sı̆l⬘ı̆-nās) A bacterial
enzyme that inactivates most but not all
penicillins.
penicillinase-producing Neisseria gonorrhoeae ABBR: PPNG. Penicillinresistant strains of Neisseria gonorrhoeae.
penicilliosis (pĕn⬙ı̆-sı̆l⬙ē-ō⬘sı̆s) [L. penicil-
lum, brush, ⫹ osis, condition] Infection with the fungi of the genus Penicillium.
Penicillium (pĕn⬙ı̆-sı̆l⬘ē-ŭm) [L. penicillum, brush] A genus of molds belonging
to the Ascomycetes (sac fungi). They
form the blue molds that grow on fruits,
bread, and cheese. A number of species
(P. chrysogenum, P. notatum) are the
source of penicillin. Occasionally in humans they produce infections of the external ear, skin, or respiratory passageways. They are common allergens. SEE:
illus.
P. marneffei A species that may
cause systemic infections, esp. in immunocompromised patients. It is found
most often in Southeast Asia, where it
frequently infects patients with acquired immunodeficiency syndrome.
penicilloyl-polylysine (pĕn⬙ı̆-sı̆l⬘oyl-pŏl⬙ĕlı̄⬘sēn) A substance used to determine
sensitivity to some forms of penicillin.
When it is injected intradermally into a
sensitive individual, a wheal appears
within 20 minutes.
penicillus (pĕn⬙ı̆-sı̆l⬘ŭs) pl. penicilli [L.,
paint brush] A group of the branches of
penis
top of rh
base of rh
PENICILLIUM IN CULTURE
arteries in the spleen that are arranged
like the bristles of a brush. Each consists of successive portions: the pulp arteries, sheathed arteries, and terminal
arteries.
penile (pē⬘nı̆l, −nı̄l) [L. penis, penis]
Pert. to the penis. SEE: penile prosthesis.
penile cuff test A means of measuring
bladder pressures during urination, in
which urinary flow is interrupted by inflating a pediatric blood pressure cuff
placed around the penis. The cuff pressure at which urinary flow stops is an
indirect, noninvasive measure of bladder pressure during urination. The test
is used to distinguish the causes of urinary hesitancy: men with prostatic hyperplasia have high bladder pressures
when they urinate, whereas men with
bladder weakness do not.
penile fracture A sudden traumatic injury to the tunica albuginea of the penis,
resulting in a rupture of the corpus cavernosum and sometimes a tearing of
the urethra. The injury typically occurs
during sexual intercourse (or, less often,
during masturbation) and may be accompanied by bleeding into the penis.
penile ring A ring made of metal, plastic,
or leather. When placed around the flaccid penis, it is small enough to prevent
venous return. Use of the device assists
in maintaining erection of the penis and
in delaying orgasm.
penis (pē⬘nı̆s) pl. penises, penes [L.]
The male organ of copulation and, in
mammals, of urination. It is a cylindrical pendulous organ suspended from the
front and sides of the pubic arch. It is
homologous to the clitoris in the female.
SEE: illus.; circumcision; penile prosthesis; Peyronie’s disease; priapism.
ANATOMY: The penis is composed
mainly of erectile tissue arranged in
three columns, the whole being covered
with skin. The two lateral columns are
the corpora cavernosa penis. The third
or median column, known as the corpus
spongiosum, contains the urethra. The
body is attached to the descending por-
short
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1736
penis
GLANS PENIS
FORESKIN
(UNRETRACTED)
pentastarch
top of rh
base of rh
HEAD OF PENIS
SHAFT OF PENIS
CORONA OF
GLANS
BUCK’S
FASCIA
CORPUS
SPONGIOSUM
CORPORA
CAVERNOSA
BULBOURETHRAL
GLANDS
CREMASTERIC
LAYER
PAMPINIFORM
PLEXUS
CROSS-SECTION
OF PENIS
INTERNAL
SPERMATIC
FASCIA
CORPUS
SPONGIOSUM
TESTIS
SKIN
BUCK’S
FASCIA
DORSAL
VEIN OF
URETHRA IN
PENIS
DISTENDED
TUNICA
STATE
VAGINALIS
CORPORA
SCROTUM
EPIDIDYMIS
MEMBRANOUS CAVERNOSA
DUCTUS
URETHRA
CREMASTER MUSCLE
SEPTUM OF SCROTUM DEFERENS
PENIS, INCLUDING TESTICLES AND SCROTUM
tion of the pubic bone by the crura of the
penis. The cone-shaped head of the penis, the glans penis, contains the urethral orifice. It is covered with a movable hood known as the foreskin or
prepuce, under which is secreted the
substance called smegma.
Hyperemia of the genitals fills the
corpora cavernosa with blood as the result of sexual excitement or stimulation,
thus causing an erection. The hyperemia subsides following orgasm and
ejaculation of the seminal fluid. The organ then returns to its flaccid condition.
The size of the flaccid penis does not
necessarily correlate with that of the
erect penis.
clubbed p. The condition in which
the penis is curved during erection.
double p. A congenital deformity in
which the penis in the embryo is completely divided by the urethral groove.
p. envy In psychoanalysis, the female’s desire to have a penis.
p. lunatus Chordee.
p. palmatus A penis enclosed by the
scrotum. SYN: webbed penis.
webbed p. Penis palmatus.
penischisis (pĕ-nı̆s⬘kı̆-sı̆s) [L. penis, penis, ⫹ Gr. schisis, a splitting] Epispadias, hypospadias, paraspadias, or any
fissured condition of the penis.
penitis (pĕ-nı̄⬘tı̆s) [⬙ ⫹ Gr. itis, inflammation] Inflammation of the penis.
pennate (pĕn⬘āt) [L. penna, feather] An
object in which parts extend at an angle
from a central portion, as do the barbs
from a feather.
(pĕn⬘ı̆-form) [⬙ ⫹ forma,
shape] Feather-shaped.
pennyroyal (pĕn⬙ı̆-roy⬘ăl) Name for various plants, esp. those of the genera
Hedeoma and Mentha, that yield commercial oil used as a carminative and
stimulant.
pennyweight (pĕn-nē-wāt) Troy weight
containing 24 gr or 1⁄20 of a troy ounce;
equal to 1.555 g. This unit of measure
was previously used for describing the
quantities of precious metals, as the
amount of gold needed for dental restorations.
pent-, penta- [Gr. pente, five] Combining
forms meaning five.
pentabasic (pĕn⬙tă-bā⬘sı̆k) A compound
that contains five replaceable hydrogen
atoms.
pentad (pĕn⬘tăd) [Gr. pente, five] 1. A
radical or element with a valence of five.
2. A group of five.
pentadactyl (pĕn⬙tă-dăk⬘tı̆l) [⬙ ⫹ daktylos, finger] Having five digits on each
hand and foot.
pentane (pĕn⬘tān) C5H12; one of the hydrocarbons of the methane series. It is a
product of petroleum distillation.
pentapeptide (pĕn⬙tă-pĕp⬘tı̆d) A polypeptide with five amino acid groups.
pentaploid (pĕn⬘tă-ployd) [⬙ ⫹ ploos, a
fold, ⫹ eidos, form, shape] Having
five sets of chromosomes.
pentastarch (pĕn⬘ tŭ-stahrch) A plasma
volume expander derived from amylopectin. It is a colloidal solution similar
to hetastarch, but with a lower average
molecular weight. It is used to support
penniform
short
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pentastomiasis
1737
blood pressure in critical situations,
such as the treatment of sepsis, shock,
or trauma.
pentastomiasis (pĕn⬙tă-stō-mı̄⬘ă-sı̆s) Infection with certain genera of Pentastomida, the tongue worms. The larval
forms usually live in the bodies of animals but have been reported in humans.
pentatomic (pĕn⬙tă-tŏm⬘ı̆k) [⬙ ⫹ atomos, indivisible] Containing five atoms
in the molecule.
pentavalent (pĕn⬙tă-vā⬘lĕnt, −tăv⬘ă-lĕnt)
[Gr. pente, five, ⫹ L. valens, having
power] Having a chemical valence of
five.
pentosazon (pĕn⬙tō-sā⬘zŏn) A crystalline compound formed when a pentose
is treated with phenylhydrazine. It is
not normally present in urine.
pentose (pĕn⬘tōs) [Gr. pente, five]
C5H10O5; a monosaccharide containing
five carbon atoms, such as ribose in
RNA and deoxyribose in DNA.
pentosemia (pĕn⬙tō-sē⬘mē-ă) Pentose in
the blood.
pentoside (pĕn⬘tō-sı̄d) Pentose combined with some other substance. Pentoses combined with purine or pyrimidine bases are present in nucleic acids,
DNA, and RNA.
pentosuria (pĕn⬙tō-sū⬘rē-ă) A condition
in which pentose is found in the urine.
pentoxide (pĕn-tŏk⬘sı̄d) A chemical molecule containing five atoms of oxygen.
penumbra (pĕ-nŭm⬘bră) 1. Healthy tissue that surrounds an ischemic or infarcted part. 2. A shadow, e.g., around a
radiographic image or at the margin of
tissue treated with radiation therapy.
PEOP model Person-Environment-Occupation-Performance model.
peotomy (pē-ŏt⬘ō-mē) [⬙ ⫹ tome, incision] Surgical removal of the penis.
Peplau, Hildegard (pĕp⬘low) A nursing
educator (1909– 1999) who developed
the Theory of Interpersonal Relations in
Nursing. SEE: Nursing Theory Appendix.
peplomer (pĕp⬘lă-mĕr) [Gr. peplos,
(woman’s) dress ⫹ Gr. meros, part] A
protein that protrudes from the lipid bilayer of an enveloped virus. A peplomer
helps the virus gain entry into a cell
with susceptible cell surface receptors.
peplos (pĕp⬘lŏs) [Gr. peplos, (woman’s)
tunic, loose-fitting robe] The lipid envelope that surrounds some viruses
(e.g., arena, corona, and filoviruses).
pepper (pĕp⬘ĕr) [ME. peper] A spice
that is used as a condiment, stimulant,
carminative, and counterirritant. The
dried berries of the fruit of plants of the
genus Piper. These are ground or used
whole to season foods. Although pepper
irritates the oral mucosa, it does not
produce peptic ulcers.
The Scoville scale is used for judging
the level of “heat” or spiciness of peppers. Using this scale, the hottest pep-
peptic ulcer
pers have a rating of 250,000 to 400,000
units. The active ingredient in chile peppers, capsaicin, may cause nasal or ocular irritation; it is wise to wear gloves,
or to wash one’s hands frequently when
handling especially spicy peppers.
peppermint (pĕp⬘ĕr-mı̆nt) A perennial
herb, Mentha piperita, cultivated for its
aromatic leaves and used as a flavoring
agent, carminative, antiemetic, and
gastrointestinal antispasmodic.
pepsic (pĕp⬘sı̆k) [Gr. peptein, to digest]
Peptic.
pepsin (pĕp⬘sı̆n) [Gr. pepsis, digestion]
The chief enzyme of gastric juice, which
converts proteins into proteoses and
peptones. It is formed by the chief cells
of gastric glands and produces its maximum activity at a pH of 1.5 to 2. It is
obtainable in granular form. In the
presence of hydrochloric acid, it digests
proteins in vitro.
pepsinogen (pĕp-sı̆n⬘ō-jĕn) [⬙ ⫹ gennan, to produce] The antecedent of pepsin existing in the form of granules in
the chief cells of gastric glands.
pepsinuria (pĕp⬙sı̆-nū⬘rē-ă) [⬙ ⫹ ouron,
urine] Excretion of pepsin in the urine.
peptic (pĕp⬘tı̆k) [Gr. peptikos] 1. Concerning digestion. 2. Concerning pepsin.
SYN: pepsic.
peptic ulcer An ulcer in the lining of the
duodenum, the lower end of the esophagus, or the stomach (usually along the
lesser curvature). Peptic ulcer disease is
a common illness, affecting about 10%
of men and 5% of women during their
lifetimes. SEE: Curling’s ulcer; Helicobacter pylori; stress ulcer; Zollinger-Ellison syndrome; Nursing Diagnoses Appendix.
ETIOLOGY: Common causes of peptic
ulcer are factors that increase gastric
acid production or impair mucosal barrier protection, such use of salicylates
and nonsteroidal anti-inflammatory
drugs (NSAIDs), tobacco smoking, Helicobacter pylori infection of the upper
gastrointestinal tract, pathologic hypersecretory disorders, consumption of
alcohol and coffee, and severe physiological stress. Ulcers occur in men and
women and occur most frequently in patients over age 65, with about 1.6 million cases diagnosed annually in the
U.S. The relationship between peptic ulcer and emotional stress is not completely understood.
SYMPTOMS: Patients with peptic ulcers may be asymptomatic or have
gnawing epigastric pain, esp. in the
middle of the night, or when no food has
been eaten for several hours. At times,
heartburn, nausea, vomiting, hematemesis, melena, or unexplained weight
loss may signify peptic disease. Food intake often relieves the discomfort. Peptic ulcers that perforate the upper gastrointestinal tract may penetrate the
top of rh
base of rh
short
standard
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peptidase
peptide
top of rh
base of rh
actions to H2-receptor antagonists and
omeprazole (dizziness, fatigue, rash, diarrhea) and the need for follow-up examination and care.
In the hospitalized patient with ulcerrelated bleeding, careful monitoring of
vital signs, fluid balance, hemoglobin
levels, and blood losses may enhance
early recognition of worsening disease.
Intravenous access is established, and
IV opiates administered as prescribed
for pain control. The patient is kept
NPO. Electrolytes and fluids are replaced as needed. Endoscopic or other
diagnostic and treatment procedures
are explained to the patient, and the effects of prescribed therapies or transfusions are carefully assessed. All patient care concerns apply after major
surgery. The patient is assessed for possible complications: hemorrhage, shock,
malabsorption problems (iron, folate, or
vitamin B12 deficiency anemias), and
dumping syndrome. In dumping syndrome, rapid gastric emptying results in
duodenal or jejunal distention, with
symptoms such as diaphoresis, weakness, nausea, flatulence, explosive diarrhea, distention, and palpitations occurring within 30 min after a meal. To
avoid this problem, the patient is advised to drink fluids between meals
rather than with meals, avoid large
amount of carbohydrates, eat 4 to 6
small, high-protein, low-carbohydrate
meals daily, and lie down after eating.
Before and after discharge, health care
professionals should help the patient to
develop coping mechanisms to relieve
anxiety. Patients are taught to recognize signs and symptoms of disease recurrence (e.g., coffee-ground emesis, the
passage of black or tarry stools, or epigastric pain). Patients who use antacid
preparations and have a history of cardiac disease or whose sodium intake is
restricted for any reason are warned to
take only those antacids that have low
amounts of sodium. The need for ongoing medical care is stressed.
peptidase (pĕp⬘tı̆-dāz) An enzyme that
converts peptides to amino acids.
peptide (pĕp⬘tı̄d) [Gr. peptein, to digest]
A compound containing two or more
linked amino acids.
brain natriuretic p. B-type natriuretic p.
B-type natriuretic p. ABBR: BNP. A
hormone secreted by the left or right
ventricle of the heart whose concentration in the bloodstream rises during episodes of decompensated heart failure.
immunodominant p. Any peptide
that has a strong affinity for binding
with class I or II histocompatibility antigens and for stimulating a response by
T lymphocytes. Immunodominant peptides are produced by antigen processing, are expressed on the surface of mac-
short
standard
1738
pancreas, causing symptoms of pancreatitis (severe back pain), and cause
chemical peritonitis followed by bacterial peritonitis or an acute abdomen as
irritating GI contents and bacteria enter the abdominal cavity. Bacterial peritonitis can lead to sepsis, shock, and
death.
DIAGNOSIS: Endoscopy (esophagogastroduodenoscopy) provides the single best test to diagnose peptic ulcers
because it allows direct visualization of
the mucosa and permits carbon 13 urea
breath testing, cytologic studies and biopsy to diagnose H. pylori, and rule out
cancer. During endoscopy, tissue can be
excised, vessels ligated, or sclerosants
injected. Barium swallow or upper gastrointestinal x-ray series may also be
used to provide images for diagnosis or
follow-up and may be the initial test for
patients whose symptoms are not severe.
Helicobacter pylori
TREATMENT:
causes most peptic ulcers in the duodenum; antibiotics (clarithromycin and
amoxicillin) are prescribed to treat H.
pylori, and antisecretory (proton pump
inhibitor) drugs like lansoprazole or
omeprazole should be given to all patients with duodenal ulcers. Bismuth or
other coating agents may be used as a
barrier to protect the duodenal mucosa.
Peptic ulceration of the stomach may be
treated with the same medications if biopsies or breath tests reveal H. pylori.
When patients have ulcers caused by
the use of NSAIDs or tobacco, withholding these agents and treating with an
H2 blocker (e.g., ranitidine) provides an
effective cure. The prostaglandin analog
misoprostol may also be used to suppress or prevent peptic ulcer caused by
NSAID use. GI bleeding is managed initially with passage of a nasogastric tube
and iced saline lavage, possibly with
norepinephrine added. Gastroscopy
then allows visualization of the bleeding
site and laser or cautery coagulation.
When conservative medical treatment
is ineffective, vagotomy and pyloroplasty may be used to reduce hydrochloric acid secretion and enlarge the pylorus to enhance gastric emptying. More
extreme surgical therapy (including
subtotal gastric resection) may be
needed in rare instances of uncontrollable hemorrhage or perforation occurring as a result of peptic ulcer disease.
PATIENT CARE: The ambulatory patient is educated about agents that increase the risk for peptic ulceration
(e.g., NSAIDs, tobacco products, excessive coffee intake, alcohol intake when
symptoms are present, stressful situations) and given specific instructions to
avoid them. Patient teaching should include the importance of adherence to
prescription drug therapies, adverse re-
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peptide
1739
rophages and other antigen-presenting
cells, and may be useful both in desensitizing people to allergens and in vaccine production. SYN: immunodominant epitope.
natriuretic p. Any peptide that stimulates the kidneys to excrete salt and
water.
peptide mapping A means of identifying
proteins electrophoretically after partially hydrolyzing them. Each protein
leaves a characteristic pattern of light
and dark peptide bands on the electrophoretic paper or gel.
peptidoglycan (pĕp-tı̆-dōglı̄săn) A large,
complex carbohydrate that forms layers
in the cell walls of bacteria. Gram-positive cell walls have many peptide-linked
layers; gram-negative cell walls have
few layers.
peptidolytic (pĕp⬙tı̆-dō-lı̆t⬘ı̆k) [⬙ ⫹ lytikos, dissolving] Causing the splitting
up or digestion of peptides.
peptidomimetics (pĕp⬙tı̆-dō-mı̆-mĕt⬘ı̆ks,
pĕp-tı̄d⬘ō-mı̄-) [⬙ ⫹ ⬙] The synthetic
alteration of a natural peptide to make
a new molecule that works in a specific
biological or therapeutic application.
peptization (pĕp⬙tı̆-zā⬘shŭn) [Gr. peptein, to digest] In the chemistry of colloids, the process of making a colloidal
solution more stable; conversion of a gel
to a sol.
Peptococcaceae (pĕp-tō-kō-kā-sēı̄) A
family of gram-positive, anaerobic cocci
that includes the genus Peptococcus and
may be normal or pathogenic inhabitants of the upper respiratory and intestinal tracts.
Peptococcus (pĕp⬙tō-kŏk⬘ŭs) A genus of
gram-positive, anaerobic cocci that are
normally present in the oral cavity, on
the skin, and in the intestinal tract.
When associated with infection, they
usually act synergistically with other
organisms.
peptogenic, peptogenous (pĕp-tō-jĕn⬘ı̆k,
−tŏj⬘ĕn-ŭs) [⬙ ⫹ gennan, to produce]
1. Producing peptones and pepsin.
2. Promoting digestion.
peptone (pĕp⬘tōn) [Gr. pepton, digesting] A secondary protein formed by the
action of proteolytic enzymes, acids, or
alkalies on certain proteins.
peptonization (pĕp⬙tō-nı̆-zā⬘shŭn) [Gr.
pepton, digesting] The action by which
proteolytic enzymes break proteins into
peptones.
peptonize (pĕp⬘tō-nı̄z) To convert into
peptones; to predigest with pepsin.
peptonuria (pĕp⬙tō-nū⬘rē-ă) [⬙ ⫹ ouron,
urine] Excretion of peptones in the
urine.
Peptostreptococcus
(pĕp⬙tō-strĕp⬙tōkŏk⬘ŭs) A genus of gram-positive anaerobic cocci of the Peptococcaceae family. They may be normal or pathogenic
inhabitants of the upper respiratory
and intestinal tracts and are an impor-
perception
tant cause of infections. Two species of
Peptostreptococcus (P. magnus and P.
micros) have been renamed as Finegoldia magnus and Micromonas magnus,
respectively.
per [L. per, through] 1. Through, by, by
means of. 2. In chemistry, the highest
valence of an element. 3. For each unit
or entity (e.g., milligrams per kilogram,
usually written as mg/kg).
per- A prefix indicating throughout,
through, utterly, intense.
peracephalus (pĕr⬙ă-sĕf⬘ă-lŭs) [⬙ ⫹ Gr.
a-, not, ⫹ kephale, head] A parasitic
placental twin. It does not contain a
head or arms, and the thorax is malformed.
peracid (pĕr-ăs⬘ı̆d) 1. An acid that contains the highest valence possible. 2. An
acid containing the peroxide group, O
9 OH.
peracute (pĕr⬙ă-kūt⬘) [⬙ ⫹ acutus,
keen] Very acute or violent.
per anum (pĕr ā⬘nŭm) [L.] Through or
by way of the anus.
perarticulation
(pĕr⬙ăr-tı̆k⬙ū-lā⬘shŭn)
[L. per, through, ⫹ articulatio, joint]
Diarthrosis.
percent (pĕr-sĕnt) Per hundred; one of
each hundred. The symbol % is used to
indicate that the preceding number is a
percentage rather than an absolute
number. Thus, 8% of 50 is 4; whereas
8% of 500 is 40.
percentage depth dose SEE: under dose.
percentile (pĕr-sĕn⬘tı̄l) One of 100 equal
divisions of a series of items or data.
Thus if a value such as a test score is
higher than 92% of all the other test
scores, that result is above the 92nd percentile of the range of scores.
percept (pĕr⬘sĕpt) The mental image of
an object seen.
perception (pĕr-sĕp⬘shŭn) [L. percepitio,
perceive] 1. Awareness of objects; consciousness. 2. The observation or receipt
of sensory information. 3. The elaboration of a sensory impression; the ideational association modifying, defining,
and usually completing the primary impression or stimulus. Vague or inadequate association occurs in confused
and depressed states.
auditory p. 1. Hearing. 2. Ability to
identify, interpret, and attach meaning
to sound.
depth p. The perception of spatial relationships; three-dimensional perception.
extrasensory p. ABBR: ESP. The
reported perception of external events
by other than the five senses.
gustatory p. Taste.
olfactory p. Smell.
stereognostic p. The recognition of
objects by touch.
tactile p. Touch.
visual p. Sight.
top of rh
base of rh
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perceptivity
percutaneous coronary
intervention
1740
perceptivity (pĕr-sĕp-tı̆v⬘ı̆-tē) The power
to receive sense impressions.
perceptual completion An optical illusion in which a boundary, color, texture,
light, or object is seen where one does
not actually exist. This defect in visual
perception, also known as “filling-in,”
commonly is experienced by people with
visual field cuts or defects (scotoma).
percolate (pĕr⬘kō-lāt) [L. percolare, to
strain through] 1. To allow a liquid to
seep through a powdered substance.
2. Any fluid that has been filtered or
percolated. 3. To strain a fluid through
powdered substances in order to impregnate it with dissolved chemicals.
percolation (pĕr⬙kō-lā⬘shŭn) [L. percolatio] 1. Filtration. 2. The process of extracting soluble portions of a drug of
powdered composition by filtering a liquid solvent through it.
percolator (pĕr⬘kō-lā⬙tor) An apparatus
used for extraction of a drug with a liquid solvent.
per contiguum (pĕr kŏn-tı̆g⬘ū-ŭm) [L.]
Touching, as in the spread of an inflammation from one part to an adjacent
structure.
per continuum (pĕr kŏn-tı̆n⬘ū-ŭm) [L.]
Continuous, as in the spread of an inflammation from part to part.
percuss (pĕr-kŭs⬘) [L. percutere] To tap
parts of the body to aid diagnosis by listening carefully to the sounds they emit.
percussion (pĕr-kŭsh⬘ŭn) [L. percussio,
a striking] 1. Striking the body surface
(usually with the fingers or a small
hammer) to determine the position,
size, or density of underlying structures.
2. A technique for mobilizing secretions
from the lungs by striking the chest wall
with cupped hands.
auscultatory p. Percussion combined
with auscultation.
bimanual p. Mediate p.
deep p. Forceful percussion used to
elicit a note from a deeply seated tissue
or organ.
direct p. Immediate p.
finger p. Striking of the examiner’s
finger as it rests upon the patient’s body
with a finger of the examiner’s other
hand.
immediate p. Percussion performed
by striking the surface directly with the
fingers. SYN: direct percussion.
indirect p. Mediate p.
mediate p. Percussion performed by
using the fingers of one hand as a plexor
and those of the opposite hand as a pleximeter. SYN: bimanual percussion; indirect percussion.
palpation p. Percussion in which the
examiner uses his or her fingers to feel
vibrations that are produced within the
body, instead of listening for the sounds
produced by striking the body.
threshold p. Percussing lightly with
the fingers on a glass-rod pleximeter,
top of rh
base of rh
the far end of which is covered with a
rubber cap. The cap is usually placed on
an intercostal space. This technique is
used to confine the percussion to a very
small area.
percussor (pĕr-kŭs⬘or) [L., striker] A
device used for diagnosis by percussion,
consisting of a hammer with a rubber or
metal head.
percutaneous (pĕr⬙kū-tā⬘nē-ŭs) [L. per,
through, ⫹ cutis, skin] Effected
through the skin; describes the application of a medicated ointment by friction, or the removal or injection of a
fluid by needle.
percutaneous blood sampling ABBR:
PUBS. Cordocentesis.
percutaneous cord blood s. Cordocentesis.
percutaneous
coronary
intervention
ABBR: PCI. Any procedure in which
catheters are placed within the coronary arteries to study them or open
them when they are obstructed. Examples of this are balloon angioplasty, atherectomy, and stent placement.
PATIENT CARE: When the patient returns to the nursing unit post-PCI procedure, the nurse should be alerted to
the type of procedure performed, the
site of the sheath, the type of the sheath,
the flush system in use, and any adverse
events that have occurred. A cardiovascular assessment is performed immediately including vital signs and an ECG.
The femoral artery, peripheral perfusion in the foot on the side of the intervention (typically the right foot), urine
output, and pain level are assessed and
documented. Physician orders are reviewed re vital signs, intravenous fluids (IV), activated clotting time, and the
plan for sheath removal. If any bleeding
is suspected, hemoglobin and hematocrit levels are checked and compared to
preprocedural values. During sheath removal two nurses work together: one
monitoring the patient while the other
removes the sheath. The patient’s IV
line must be patent, with fluid infusing
and 500 mL normal saline available. A
bedside monitor with noninvasive blood
pressure capability, an ECG, and pulse
oximeter should also be available. The
patient is placed in a supine position,
the dressing removed, and the arterial
puncture site inspected for bleeding or
hematoma. The patient should be advised that he will probably feel mild to
moderate discomfort and pressure during and after sheath removal. Pain relievers are provided as prescribed. A syringe is attached to the stopcock, and
blood drawn to ensure there is no clot in
the sheath. If a suture has been used to
close the access site, it is then removed.
The femoral artery is palpated, and
pressure applied using fingers placed
along the artery, beginning about 1 cm
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percutaneous electrical nerve
stimulation
1741
above the puncture site because the
sheath is inserted on an angle and
therefore enters the artery proximal to
the skin puncture site. Using the free
hand, the nurse then gently withdraws
the sheath (pulling it toward the patient’s foot). Manual pressure is maintained on the site to stop bleeding but
should not be strong enough to obscure
the pedal pulse (checked by nurse #2).
The site is re-examined for bleeding,
swelling, and hematoma formation. Vital signs are assessed every 3 to 5 min
after the sheath is removed. Continuous
manual pressure or mechanical compression should be applied to an arterial
site for 10 to 20 min or longer, and to a
venous site for 10 min. When bleeding
has ceased, compression is discontinued, and a dressing is applied to the
insertion site. The head of the bed may
now be elevated slightly. Frequent patient assessment continues according to
agency protocol, typically q15m X4,
then q30m X4, then q1h X4. Bedrest is
maintained for 2 to 6 hr (longer if the patient is not stable), with the affected leg
kept straight to minimize insertion site
bleeding. This position may be uncomfortable, and the patient may require reminders to maintain it. Oral intake can
be resumed once the sheath has been removed and the potential for vasovagalinduced vomiting has passed. The
dressing is removed after 24 h and the
wound assessed for complications. Vascular closure devices (suture-placement
and collagen-delivery) may be employed. Adverse reactions to sheath removal include bleeding, hypotension
(during or following removal), or vasovagal-induced bradycardia. The patient
is assessed for symptoms such as dizziness, altered mental status, nausea,
bradycardia, or hypotension. Patients
must be monitored for complications related to PCI (e.g., coronary ischemia,
contrast-induced nephropathy, and insertion-site problems). Trauma to the
femoral vessels may be minor or serious, and when patients have both femoral arterial and venous sheaths, the arterial sheath is removed first to reduce
the risk of vascular complications.
Bleeding frequently complicates the
procedure. For mild bleeding, pressure
is applied to the puncture site; for more
serious bleeding (e.g., bleeding that
compromises vital signs or the punctured limb), pressure is applied, and the
cardiologist or a vascular surgeon notified. Ecchymosis is common at the site
immediately or after dressing removal,
often extending into surrounding tissues and accompanied by pain and minor swelling. Retroperitoneal hematoma should be suspected if the patient
experiences flank, abdominal, or back
perfluorocarbon
top of rh
base of rh
pain, unexplained hypotension, or a
marked drop in hematocrit. Other complications include arterial occlusion by
clot formation, pseudoaneurysm, arteriovenous fistula, and infection. The patient and family should receive clear
written and verbal instructions for
home care before discharge. The patient
should be advised to avoid strenuous activities for 3 days after a PCI and not to
attempt to lift anything heavier than 10
lb until after a follow-up visit with the
cardiologist. Reclining is recommended
rather than sitting. The patient may
shower, but should not take tub baths
or swim until the groin site is fully
healed. If a dressing is in place, it may
be removed in 24 hr, and the site kept
clean and dry. Some bruising and development of a small lump at the site
are normal. If light bleeding occurs, the
patient or a family member should apply pressure to the site for 10 minutes
and then apply an adhesive bandage.
For heavy bleeding, pressure should be
applied 1 in above the puncture site and
911 should be called. The site should
also be observed for infection (redness,
warmth, pain, drainage) and the physician notified if any of these signs occur.
percutaneous electrical nerve stimulation ABBR: PENS. A treatment for
pain in which weak electrical currents
are applied to acupuncture needles inserted into trigger points or dermatomes near painful body parts. PENS is
sometimes used to treat episodic low
back pain and other regional pain syndromes. It may be used as an alternative to TENS.
percutaneous nephrolithotomy ABBR:
PNL. The removal of stones from the
urinary tract with a needle inserted
through the skin and into the urinary
collecting system. The collecting system
near the stone is dilated, and the stone
is grasped and/or crushed.
per diem cost (pĕr-dē-ĕm) Daily expenses.
perencephaly (pĕr⬙ĕn-sĕf⬘ă-lē) [Gr. pera,
pouch, ⫹ enkephalos, brain] Porencephalia.
perennial Throughout the entire year.
Said of diseases, such as some cases of
allergic rhinitis, which do not have a
peak incidence in one season.
perfectionism (pĕr-fĕk⬘shŭn-ı̆zm) A personality trait in which the individual
strives for achievement in a manner
that borders on the obsessive or the depressive.
perflation (pĕr-flā⬘shŭn) [L. perflatio]
The process of blowing air into a cavity
to expand its walls or to force out secretions or other matter.
perfluorocarbon (pĕr-floor⬙-ă-kahr⬘ bŭn,
−floo⬙ă-rō-) A class of solvent molecules
that can carry nonpolar gases, such as
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perforans
1742
oxygen, nitrogen, and carbon dioxide.
They have been used experimentally in
transfusion medicine and in some ophthalmic surgeries. Perfluorocarbons are
also used as blood gas controls when
prepared in buffered solutions equilibrated with CO2 and O2.
perforans (pĕr⬘fō-răns) [L.] Perforating
or penetrating, as a nerve or blood vessel through a nerve or a muscle.
perforate (pĕr⬘fō-rāt) [L. perforatus,
pierced with holes] 1. To puncture or to
make holes. 2. Pierced with holes.
perforating disorder Any of several rare
conditions associated with diabetes mellitus and/or chronic kidney disease in
which dermal components, such as collagen or elastin, protrude through the
epidermis. The perforating disorders include elastosis perforans serpiginosa,
Kyrle disease, perforating folliculitis,
and reactive perforating collagenosis,
but some experts believe that all of
these conditions reflect the same disease.
perforation (pĕr⬙fō-rā⬘shŭn) 1. The act
or process of making a hole, such as that
caused by ulceration. 2. A hole made
through a structure or part.
nasal septal p. A hole through the
nasal septum, usually the result of
chronic inflammation caused by infection or repeated cocaine inhalation.
p. of stomach or intestine An abdominal crisis in which a hole forms in
a wall of the gastrointestinal tract, resulting in the release of intestinal fluids
into the peritoneum. The leakage may
produce a localized abscess, phlegmon,
or diffuse peritonitis. SYN: intestinal
perforation. SEE: peritonitis.
SYMPTOMS: The onset is accompanied by acute pain, beginning over the
perforated area and spreading all over
the abdomen. Nausea and vomiting,
tachycardia, hypotension, fevers, chills,
sweats, confusion, and decreased urinary output are common.
TREATMENT: Surgical treatment is
necessary. Pending operation, the patient is given no oral fluids; parenteral
fluids, antibiotics, and other medications are administered.
tooth p. An opening through the wall
of a tooth, produced by pathologic processes or accidentally, thereby exposing
the dental pulp. It is also called pulp exposure.
perforator (pĕr⬘fō-rā-tor) [L., a piercing
device] 1. An instrument for piercing
the skull and other bones. 2. A blood
vessel that penetrates an organ (e.g. the
septal perforator arteries of the heart);
any of the perforating veins of the lower
extremities
tympanum p. An instrument used to
perforate the tympanum.
perforatorium (pĕr⬙fō-ră-tō⬘rē-ŭm) The
perfusion
top of rh
base of rh
pointed tip of the acrosome of the spermatozoa.
perforin (pĕr⬘ fŭ-rı̆n) One of a group of
membrane-altering proteins released
from natural killer cells and cytotoxic T
cells that drill holes in cell membranes,
causing affected cells to die. Perforins
contribute to innate immune defenses
against viruses and tumors.
performance (pĕr-fŏr-măns) 1. The undertaking and completion of mental or
physical work. In rehabilitation, a person’s performance is observed and
measured to determine functional capability. 2. An accomplishment; the fulfillment of a task.
performance area Functional classifications of tasks and roles used by occupational therapists for assessment and
goal-setting, including activities of daily
living, work and other productive activities, and leisure and play.
Performance Assessment of Self-Care
Skills ABBR: PASS. A formal means
of gauging an adult’s capacity to thrive
independently that measures home
management and personal care skills,
mobility, safety, and outcome.
performance-based physical function
test ABBR: PPF. A four-component
assessment of physical functioning. The
PPF includes:
1. the time it takes a subject to walk
10 feet;
2. the time it takes to stand up from
a seated position in a chair five consecutive times;
3. the grip strength in the dominant
hand; and
4. a test of balance and stability.
Each component of the test is given a score
from 0 to 4. The highest possible score
on the test, indicating optimal physical
functioning, is 16.
performance improvement ABBR: PI.
Any enhancement in health care operations (e.g., communications, laboratory
operations, patient safety, profitability,
resource utilization).
Performance IQ A synonym for “nonverbal intelligence” as measured by standard psychometric tests.
performance measure Any criterion
used to assess the efficiency or the quality of health care.
perfusate (pĕr-fū⬘zāt) The fluid used to
perfuse a tissue or organ.
perfuse (pĕr-fūz⬘) [L. perfundere, to
moisten (all over)] To force or instill
(fluids) into an organ or a vessel.
perfusion (pĕr-fū⬘zhŭn) [L. perfundere,
to pour through] 1. The circulation of
blood through tissues. 2. Passing of a
fluid through spaces. 3. Pouring of a
fluid. 4. Supplying of an organ or tissue
with nutrients and oxygen by injecting
blood or a suitable fluid into an artery.
coronary p. The passage of blood
through the arteries of the heart.
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perfusionist
1743
perfusionist (pĕr-fū⬘zhŭn-ı̆st) A health
care professional, formally known as a
clinical perfusion scientist, who manages extracorporeal circulation of blood
and operates the heart-lung machine.
perhydrocyclopentanophenanthrene (pĕrhı̄⬙drō-sı̄⬙klō-pĕn-tăn⬙ō-phĕn-ăn⬘thrēn)
The name of the ring structure of the
chemical nucleus of the steroids. SEE:
steroid hormone for illus.
peri- [Gr.] Prefix meaning around,
about.
periadenitis (pĕr⬙ē-ă⬙dĕ-nı̄⬘tı̆s) [⬙ ⫹
aden, gland, ⫹ itis, inflammation] Inflammation of the tissues surrounding a
gland.
p. mucosa necrotica recurrens An
obsolete term for recurrent aphthous ulcers of the mouth, also known as Sutton’s ulcers.
perianal (pĕr⬙ē-ā⬘năl) [⬙ ⫹ L. anus,
anus] Around or close to the anus.
periangiitis (pĕr⬙ē-ăn⬙jē-ı̄⬘tı̆s) [⬙ ⫹ angeion, vessel, ⫹ itis, inflammation]
Inflammation of tissue around a blood
or lymphatic vessel.
periangiocholitis (pĕr⬙ē-ăn⬙jē-ō-kō-lı̄⬘tı̆s)
[⬙ ⫹ ⬙ ⫹ chole, bile, ⫹ itis, inflammation] Pericholangitis.
periaortic (pĕr⬙ē-ā-or⬘tı̆k) [⬙ ⫹ aorte,
aorta] Around the aorta.
periaortitis
(pĕr⬙ē-ā-or-tı̄⬘tı̆s)
[⬙
⫹
aorte, aorta, ⫹ itis, inflammation] Inflammation of adventitia and tissues
around the aorta.
periapex (pĕr⬙ē-ā⬘pĕks) [⬙ ⫹ L. apex,
tip] The area around the apex of a
tooth.
periapical (pĕr⬙ē-ăp⬘ı̆-kăl) [⬙ ⫹ L. apex,
tip] Around the apex of the root of a
tooth.
periappendicitis (pĕr⬙ē-ă-pĕn⬙dı̆-sı̄⬘tı̆s) [⬙
⫹ L. appendix, appendage, ⫹ Gr. itis,
inflammation] Inflammation of the tissues surrounding the appendix secondary to either appendicitis or other intraperitoneal inflammatory process.
p. decidualis A condition in which
decidual cells exist in the peritoneum of
the appendix vermiformis in cases of tubal pregnancy owing to adhesions between fallopian tubes and the appendix.
periappendicular (pĕr⬙ē-ăp⬙ĕn-dı̆k⬘ū-lăr)
[⬙ ⫹ L. appendix, appendage] Surrounding an appendix.
periarterial (pĕr⬙ē-ăr-tē⬘rē-ăl) [⬙ ⫹ arteria, artery] Placed around an artery.
periarteriolar lymphoid sheath (pĕr⬙ēahr-tı̆r⬘ē-ō⬘lĕr) ABBR: PALS. A region
of the spleen that encircles the splenic
arteries and is composed mostly of T
cells. It comprises the tissues sometimes referred to as the white pulp of
the organ.
periarteritis (pĕr⬙ē-ăr-tĕr-ı̄⬘tı̆s) [⬙ ⫹ ⬙
⫹ itis, inflammation] Inflammation of
the external coat of an artery.
p. gummosa Gummas in the blood
vessels in syphilis.
pericarditis
p. nodosa Polyarteritis nodosa. SEE:
Nursing Diagnoses Appendix.
periarthritis (pĕr⬙ē-ăr-thrı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
itis, inflammation] Inflammation of the
area around a joint.
periarticular (pĕr⬙ē-ăr-tı̆k⬘ū-lăr) Circumarticular.
periauricular (pĕr⬙ē-ăw-rı̆k-ū-lăr) Around
the ear.
periaxial (pĕr-ē-ăk⬘sē-ăl) [⬙ ⫹ axon,
axis] Located around an axis.
peribronchiolar (pĕr⬙ı̆-brŏng⬙kē-ō⬘lăr) [⬙
⫹ L. bronchiolus, bronchiole] Surrounding a bronchiole.
peribronchiolitis (pĕr⬙ı̆-brŏng⬙kē-ō-lı̄⬘tı̆s)
[⬙ ⫹ ⬙ ⫹ Gr. itis, inflammation] Inflammation of the area around the bronchioles.
pericardiectomy (pĕr⬙ı̆-kăr-dē-ĕk⬘tō-mē)
[⬙ ⫹ ⬙ ⫹ ektome, excision] Puncturing or perforation of the pericardium or
creation of a pericardial window, for example, to relieve a pericardial effusion
responsible for cardiac tamponade.
pericardiocentesis
(pĕr⬙ı̆-kăr⬙dē-ō-sĕntē⬘sı̆s) [⬙ ⫹ ⬙ ⫹ kentesis, puncture]
Surgical perforation of the pericardium.
This procedure is used to aspirate pericardial fluid. SEE: illus.
pericardiolysis (pĕr⬙ı̆-kăr⬙dē-ŏl⬘ı̆-sı̆s) [⬙
⫹ ⬙ ⫹ lysis, dissolution] Separation
of adhesions between the visceral and
parietal pericardium.
pericardiomediastinitis (pĕr⬙ı̆-kăr⬙dē-ōmē-dē-ăs⬙tı̆-nı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹ L. mediastinum, ⫹ Gr. itis, inflammation] Inflammation of the pericardium and
mediastinum.
pericardiopexy
(păr-ē-kăr-dē-ō-pĕks-ē)
[⬙ ⫹ ⬙ ⫹ pexis, fixation] A surgical
procedure designed to increase the
blood supply to the heart by joining the
pericardium to an adjacent tissue.
pericardiophrenic
(pĕr-ı̆-kăr⬙dē-ōfrĕn⬘ı̆k) [⬙ ⫹ kardia, heart, ⫹ phren,
diaphragm] Concerning the pericardium and diaphragm.
pericardiopleural
(pĕr⬙ı̆-kăr⬙dē-ōploo⬘răl) [⬙ ⫹ ⬙ ⫹ pleura, rib] Concerning the pericardium and pleura of
the lungs.
pericardiorrhaphy (pĕr⬙ı̆-kăr⬙dē-or⬘ă-fē)
[⬙ ⫹ ⬙ ⫹ rhaphe, seam, ridge] Suture
of a wound in the pericardium.
pericardiostomy (pĕr⬙ı̆-kăr⬙dē-ŏs⬘tō-mē)
[⬙ ⫹ kardia, heart, ⫹ stoma, mouth]
Formation of an opening into the pericardium for drainage.
pericardiosymphysis
(pĕr⬙ı̆-kăr⬙dē-ōsı̆m⬘fı̆-sı̆s) [⬙ ⫹ ⬙ ⫹ symphysis, a joining] Adhesion between the layers of the
pericardium.
pericardiotomy (pĕr⬙ı̆-kăr-dē-ŏt⬘ō-mē) [⬙
⫹ ⬙ ⫹ tome, incision] Incision of the
pericardium.
pericarditis (pĕr-ı̆-kăr-dı̄⬘tı̆s) [⬙ ⫹ kardia, heart, ⫹ itis, inflammation] Inflammation of the pericardium, marked
by chest pain, fever, and an audible fric-
top of rh
base of rh
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1744
pericarditis
pericarditis
top of rh
base of rh
Myocardium
Xiphoid
Pericardial
fluid
16- to 18-gauge
needle
Drainage port
Parietal
pericardium
Visceral
pericardium
PERICARDIOCENTESIS
tion rub. SEE: Dressler’s syndrome;
Nursing Diagnoses Appendix.
ETIOLOGY: Many diseases and conditions can inflame the membranous
covering of the heart, including infections (bacterial, tubercular, viral, fungal); collagen-vascular diseases (e.g.,
rheumatic fever, rheumatoid arthritis,
or systemic lupus erythematosus);
drugs (hydralazine, procainamide, isoniazid, minoxidil); myocardial infarction; cancer; renal failure; cardiac surgery; or trauma. In many instances, the
precise cause is unknown (in these cases
the inflammation is called idiopathic).
SYMPTOMS: Chest pain that varies
with respiration is a hallmark of pericarditis. The pain often worsens when
the patient lies down and improves
when the patient sits up and leans forward. It is usually described as sharp
and constant, and located in the midchest (retrosternally), but may radiate
to the neck, shoulder, and back. Fever,
cough, dyspnea, and palpitations also
are characteristic. The classic sign of
pericarditis is a friction rub (found in
about 50% of cases), a multicomponent
abnormal heart sound that some observers describe as being high-pitched,
scratchy, raspy, grating, or leathery. It
is best heard with the diaphragm of the
stethoscope at the left lower sternal border as the patient sits up, leans forward,
and holds his/her breath after expiration.
DIAGNOSIS: Diagnosis is usually
based on the clinical presentation, ECG
changes, and echocardiography.
TREATMENT: Therapy depends on
the cause of the syndrome. Uremic pericarditis, e.g., is treated with dialysis,
whereas pyogenic pericarditis requires
antibiotic therapy and drainage. Prednisone or other anti-inflammatory
drugs improve pericardial pain in patients with idiopathic disease. Many
cases of pericarditis are self-limiting,
but without treatment others may progress to chronic constrictive pericarditis
or cardiac tamponade.
PATIENT CARE: The patient is observed closely for symptoms of cardiac
tamponade, such as pallor and clammy
skin, pulsus paradoxus (systolic blood
pressure at least 10 mm Hg lower during slow inspiration than during expiration), weak or absent peripheral
pulses, distended neck veins, decreased
blood pressure, and narrowing pulse
pressure. Patients with chronic constrictive pericarditis usually require a
total pericardectomy to permit adequate filling and contraction of the
heart. If surgery is required, the patient
is taught deep-breathing and coughing
(incentive spirometry) exercises beforehand as time permits. Postoperative
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pericarditis
1745
care will be similar to that for other cardiothoracic surgical patients. Medications are administered as prescribed.
Activities are restricted and vigorous
exercise should be avoided until pain
and fever subside, which may take
weeks to months. In the convalescent
phase, the patient is taught about the
importance of taking prescribed medications, their purposes, and any potentially recurring symptoms to report. The
patient is encouraged to keep all scheduled follow-up appointments and to notify the primary health care provider
immediately if changes in symptoms occur, such as return or worsening of pain,
difficulty breathing, irregular heart
beats, or loss of consciousness.
adhesive p. An old term for constrictive pericarditis.
constrictive p. Scarring of the pericardium after one or more episodes of
pericarditis. This limits normal cardiac
filling during diastole. Impaired filling
of the heart chambers reduces the volume of blood ejected by the heart with
each contraction. The patient often complains of shortness of breath. On physical examination, elevated neck veins,
ascites, hepatic enlargement, and lower
extremity edema often are found. Surgical stripping of the pericardium (pericardiectomy) is used to relieve the constriction.
external p. Inflammation of the exterior surface of the pericardium.
fibrinous p. Pericarditis in which the
membrane is covered with a butter-like
exudate that organizes and unites the
pericardial surfaces.
SYMPTOMS: The condition is characterized by symptoms of heart failure
(e.g., dyspnea, generalized edema, cyanosis).
hemorrhagic p. Pericarditis in which
the exudate contains blood.
idiopathic p. Acute nonspecific pericarditis.
ischemic p. Pericarditis resulting
from myocardial infarction.
neoplastic p. Pericarditis due to invasion of the pericardium by cancer.
p. obliterans Pericardial inflammation causing adhesions and obliteration
of the pericardial cavity.
serofibrinous p. Pericarditis in
which there is a considerable quantity
of serous exudate but little fibrin.
uremic p. Pericarditis associated
with end-stage renal failure or hemodialysis. It indicates the need for more frequent or more intensive dialysis.
pericardium (pĕr⬙ı̆-kăr⬘dē-ŭm) [Gr. peri,
around, ⫹ kardia, heart] The membranous fibroserous sac enclosing the
heart and the bases of the great vessels.
Its three layers are the fibrous pericardium (the outer layer); the parietal pericardium, a serous membrane that lines
pericardium
top of rh
base of rh
the fibrous pericardium; and the visceral pericardium (epicardium), a serous membrane on the surface of the
myocardium. The space between the
two serous layers is the pericardial cavity, a potential space filled with serous
fluid that reduces friction as the heart
beats. Its base is attached to the diaphragm, its apex extending upward as
far as the first subdivision of the great
blood vessels. It is attached in front to
the sternum, laterally to the mediastinal pleura, and posteriorly to the esophagus, trachea, and principal bronchi.
SEE: illus.
PARIETAL
PERICARDIUM
ENDOCARDIUM
FIBROUS PERICARDIUM
(PERICARDIAL SAC)
MYOCARDIUM
(HEART MUSCLE)
PERICARDIAL CAVITY
EPICARDIUM
(VISCERAL
PERICARDIUM)
PERICARDIUM AND LAYERS OF THE
HEART WALL
adherent p. A condition in which fibrous bands form between the two serous layers of the pericardium, obliterating the pericardial cavity. SEE:
pericarditis, constrictive.
bread-and-butter p. A pathological
appearance seen in fibrinous pericarditis, in which the pericardium has a peculiar appearance as a result of fibrinous deposits on the two opposing
surfaces.
fibrous p. The outer fibrous layer of
the pericardium; it extends over the bases of the great vessels and the upper
surface of the diaphragm.
parietal p. The middle layer of the
pericardial sac, a serous membrane lining the fibrous pericardium.
serous p. A flattened sac formed of a
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pericardium
periendothelioma
top of rh
base of rh
brous membrane surrounding the cranium; periosteum of the skull.
pericystic (pĕr⬙ı̆-sı̆s⬘tı̆k) [⬙ ⫹ kystis,
bladder] Surrounding a cyst.
pericystitis (pĕr⬙ı̆-sı̆s-tı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
itis, inflammation] Inflammation of the
tissues about the bladder.
pericyte (pĕr⬘ı̆-sı̄t) [⬙ ⫹ kytos, cell] A
stem cell that may give rise to smooth
muscle cells; often found around capillaries.
pericytial (pĕr-ı̆-sı̆sh⬘ăl) [⬙ ⫹ kytos, cell]
Placed around a cell.
peridens (pĕr⬘ı̆-dĕns) [⬙ ⫹ L. dens,
tooth] A supernumerary tooth not situated in the dental arch.
peridental (pĕr⬙ı̆-dĕn⬘tăl) [⬙ ⫹ L. dens,
tooth] Surrounding a tooth or part of
one. SYN: periodontal.
peridentitis (pĕr-ē-dĕn-tı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
itis, inflammation] Inflammation of tissues surrounding a tooth. SYN: periodontoclasia.
peridentium (pĕr⬙ı̆-dĕn⬘tē-ŭm) [⬙ ⫹ L.
dens, tooth] Periodontium.
periderm (pĕr⬘ē-dĕrm) [⬙ ⫹ derma,
skin] A thin layer of flattened cells
forming a transient layer of embryonic
epidermis. SYN: epitrichial layer; epitrichium.
peridesmitis (pĕr⬙ı̆-dĕz-mı̄⬘tı̆s) [⬙ ⫹
desmion, band, ⫹ itis, inflammation]
Inflammation of the areolar tissue
around a ligament.
peridesmium (pĕr⬙ı̆-dĕz⬘mē-ŭm) The
connective tissue membrane sheathing
a ligament.
perididymis (pĕr⬙ı̆-dı̆d⬘ı̆-mı̆s) [⬙ ⫹ didymos, testicle] The tunica vaginalis of
the testicle.
perididymitis (pĕr⬙ı̆-dı̆d⬙ı̆-mı̄⬘tı̆s) [⬙ ⫹ ⬙
⫹ itis, inflammation] Inflammation of
the perididymis.
peridiverticulitis (pĕr⬙ı̆-dı̄⬙vĕr-tı̆k⬙ū-lı̄⬘tı̆s)
[⬙ ⫹ L. diverticulare, to turn aside, ⫹
Gr. itis, inflammation] Inflammation of
tissues situated around an intestinal diverticulum.
periductal (pĕr-ı̆-dŭk⬘tăl) [⬙ ⫹ L. ductus, a passage] Situated around a duct.
periduodenitis (pĕr⬙ı̆-dū⬙ō-dĕ-nı̄⬘tı̆s) [⬙
⫹ L. duodeni, twelve, ⫹ Gr. itis, inflammation] Inflammation around the
duodenum, often causing adhesions attaching it to the peritoneum.
peridural (pĕr⬙ı̆-dū⬘răl) [⬙ ⫹ L. durus,
hard] Outside the dura mater.
periencephalitis (pĕr⬙ē-ĕn-sĕf⬙ă-lı̄⬘tı̆s) [⬙
⫹ enkephalos, brain, ⫹ itis, inflammation] Inflammation of the surface of
the brain.
periencephalomeningitis
(pĕr⬙ē-ĕn-sĕf
⬙ă-lō-mĕn⬙ı̆n-jı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹ meninx,
membrane, ⫹ itis, inflammation] Inflammation of the cerebral cortex and
meninges.
periendothelioma
(pĕr⬙ē-ĕn⬙dō-thē⬙lēō⬘mă) [⬙ ⫹ endon, within, ⫹ thele,
nipple, ⫹ oma, tumor] A tumor aris-
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1746
single layer of cells and connective tissue.
shaggy p. A condition occurring in fibrinous pericarditis in which loose
shaggy deposits of fibrin are seen on the
surfaces of the pericardium.
visceral p. The side of the sac attached to the external surface of the
heart. SYN: epicardium.
pericecitis (pĕr⬙ı̆-sē-sı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹ ⬙]
Inflammation surrounding the cecum.
pericellular (pĕr⬙ı̆-sĕl⬘ū-lăr) [⬙ ⫹ L. cellula, cell] Around a cell.
pericemental (pĕr⬙ı̆-sē-mĕn⬘tăl) [⬙ ⫹ L.
caementum, cement] Concerning the
pericementum (i.e., the periodontal ligament).
pericementitis (pĕr⬙ı̆-sē-mĕn-tı̄⬘tı̆s) [⬙ ⫹
⬙ ⫹ Gr. itis, inflammation] Periodontitis.
apical p. Apical abscess of the tooth.
pericementum (pĕr⬙ı̆-sē-mĕn⬘tŭm) Periodontal ligament.
pericholangitis (pĕr⬙ı̆-kō-lăn-jı̄⬘tı̆s) [Gr.
peri, around, ⫹ chole, bile, ⫹ angeion, vessel, ⫹ itis, inflammation]
Inflammation of tissues surrounding a
bile duct. SYN: periangiocholitis.
pericholecystitis (pĕr⬙ı̆-kō-lē-sı̆s-tı̄⬘tı̆s) [⬙
⫹ ⬙ ⫹ kystis, a sac, ⫹ itis, inflammation] Inflammation of tissues situated around the gallbladder.
perichondritis (pĕr-ı̆-kŏn-drı̄⬘tı̆s) [⬙ ⫹ ⬙
⫹ itis, inflammation] Inflammation of
the perichondrium.
perichondrium (pĕr-ı̆-kŏn⬘drē-ŭm) [⬙ ⫹
chondros, cartilage] Fibrous connective
tissue that surrounds cartilage.
perichondroma (pĕr⬙ı̆-kŏn-drō⬘mă) [⬙ ⫹
⬙ ⫹ oma, tumor] A tumor arising from
fibrous tissue that covers cartilage.
perichorioidal, perichoroidal (pĕr⬙ı̆-kōrē-oy⬘dăl, −roy⬘dăl) [⬙ ⫹ chorioeides,
skinlike] Situated around the choroid
coat.
pericolic (pĕr-ı̆-kō⬘lı̆k) [⬙ ⫹ kolon, colon] Around or encircling the colon.
pericolitis (pĕr⬙ı̆-kō-lı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹ ⬙]
Inflammation surrounding the colon.
pericolpitis (pĕr⬙ı̆-kŏl-pı̄⬘tı̆s) [Gr. peri,
around, ⫹ kolpos, vagina, ⫹ itis, inflammation] Inflammation of connective tissues surrounding the vagina.
pericorneal (pĕr⬙ı̆-kor⬘nē-ăl) [⬙ ⫹ L.
cornu, horn] Placed around the cornea.
pericoronal (pĕr⬙ı̆-kor⬘ō-năl) [⬙ ⫹ korone, crown] Around the crown of a
tooth.
pericoronitis (pĕr⬙ı̆-kor⬙ō-nı̄⬘tı̆s) [⬙ ⫹ ⬙
⫹ itis, inflammation] Abscess around
the crown of an unerupted molar. SYN:
pericoronal abscess.
pericranial (pĕr⬙ı̆-krā⬘nē-ăl) [⬙ ⫹ kranion, skull] Pert. to the periosteum of
the skull.
pericranitis (pĕr⬙ı̆-krā-nı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
itis, inflammation] Inflammation of the
pericranium.
pericranium (pĕr⬙ı̆-krā⬘nē-ŭm) The fi-
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
perienteric
1747
ing from the endothelium of the lymphatics and the perithelium of blood
vessels.
perienteric (pĕr⬙ē-ĕn-tĕr⬘ı̆k) [Gr. peri,
around, ⫹ enteron, intestine] Around
the intestines.
perienteritis (pĕr⬙ē-ĕn⬙tĕr-ı̄⬘tı̆s) [⬙ ⫹ ⬙
⫹ itis, inflammation] Inflammation of
the intestinal peritoneum.
perienteron (pĕr⬙ē-ĕn⬘tĕr-ŏn) [⬙ ⫹ enteron, intestine] The peritoneal cavity
of the embryo.
periesophagitis (pĕr⬙ē-ĕ-sŏf⬙ă-jı̄⬘tı̆s) [⬙
⫹ oisophagos, esophagus, ⫹ itis, inflammation] Inflammation of the tissues around the esophagus.
perifistular (pĕr-ı̆-fı̆s⬘tū-lĕr) [⬙ ⫹ L. fistula, pipe] Located around a fistula.
perifocal (pĕr⬙ı̆-fō⬘kăl) [⬙ ⫹ L. focus,
hearth] Around a focus, esp. around an
infected focus.
perifollicular (pĕr⬙ı̆-fŏl-lı̆k⬘ū-lăr) [⬙ ⫹ L.
folliculus, a little sac] Around a follicle.
perifolliculitis (pĕr⬙ı̆-fō-lı̆k⬙ū-lı̄⬘tı̆s) [⬙ ⫹
⬙ ⫹ Gr. itis, inflammation] Inflammation around hair follicles.
perigangliitis (pĕr⬙ı̆-găng⬙lē-ı̄⬘tı̆s) [⬙ ⫹
ganglion, knot, ⫹ itis, inflammation]
Inflammation around a ganglion.
periganglionic (pĕr⬙ı̆-găng⬙glē-ŏn⬘ı̆k) [⬙
⫹ ganglion, knot] Around a ganglion.
perigastritis (pĕr⬙ı̆-găs-trı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
itis, inflammation] Inflammation of the
peritoneal covering of the stomach.
periglandulitis (pĕr⬙ı̆-glăn⬙dū-lı̄⬘tı̆s) [⬙ ⫹
L. glandula, small gland, ⫹ Gr. itis,
inflammation] Inflammation of tissues
around a gland.
perihepatic (pĕr⬙ı̆-hē-păt⬘ı̆k) [Gr. peri,
around, ⫹ hepar, liver] Around the
liver.
perihepatitis (pĕr⬙ı̆-hĕp-ă-tı̄⬘tı̆s) [⬙ ⫹ ⬙
⫹ itis, inflammation] Inflammation of
the peritoneal covering of the liver, e.g.,
in Fitz-Hugh-Curtis syndrome.
perihernial (pĕr⬙ı̆-hĕr⬘nē-ăl) [⬙ ⫹ L.
hernia, rupture] Around a hernia.
perijejunitis (pĕr⬙ı̆-jē-jū-nı̄⬘tı̆s) [⬙ ⫹ L.
jejunum, empty, ⫹ Gr. itis, inflammation]
Inflammation of tissues
around the jejunum.
perikaryon (pĕr⬙ı̆-kăr⬘ē-ŏn) [⬙ ⫹ karyon, nucleus] The cell body of a neuron.
perikeratic (pĕr⬙ı̆-kĕr-ă⬘tı̆k) [⬙ ⫹ keras,
horn] About the cornea. SYN: pericorneal.
perikymata (pĕr⬙ı̆-kı̄⬘mă-tă) [⬙ ⫹ kyma,
wave] The transverse wavelike grooves
most apparent in the surface enamel of
newly erupted anterior teeth; they are
more pronounced at eruption and are
reduced in depth with wear in advancing age.
perilabyrinthitis
(pĕr⬙ı̆-lăb⬙ı̆r-ı̆n-thı̄⬘tı̆s)
[⬙ ⫹ labyrinthos, a maze of canals, ⫹
itis,
inflammation]
Inflammation
around the labyrinth.
perilaryngeal (pĕr⬙ı̆-lă-rı̆n⬘jē-ăl) [⬙ ⫹
larynx, larynx] Around the larynx.
perimetry
top of rh
base of rh
perilaryngitis (pĕr⬙ı̆-lăr⬙ı̆n-jı̄⬘tı̆s) [⬙ ⫹ ⬙
⫹ itis, inflammation] Inflammation
around the larynx.
perilenticular (pĕr⬙ı̆-lĕn-tı̆k⬘ū-lăr) [⬙ ⫹
L. lenticularis, pert. to a lens] Around
the lens of the eye.
perilingual (pĕr⬙ı̆-lı̆ng⬘gwı̆l) [⬙ ⫹ ⬙] Occurring during the development of
speech and language.
perilymph, perilympha (pĕr⬘ı̆-lı̆mf, pĕr⬙ı̆lı̆m⬘fă) [⬙ ⫹ L. lympha, serum] The
pale, transparent fluid within the bony
(not the vestibular) labyrinth of the inner ear.
perilymphangeal (pĕr⬙ı̆-lı̆m-făn⬘jē-ăl) [⬙
⫹ ⬙ ⫹ Gr. angeion, vessel] Around a
lymphatic vessel.
perilymphangitis (pĕr⬙ı̆-lı̆mf-ăn-jı̄⬘tı̆s) [⬙
⫹ ⬙ ⫹ ⬙ ⫹ itis, inflammation] Inflammation of tissues around a lymphatic vessel.
perimastitis (pĕr⬙ı̆-măs-tı̄⬘tı̆s) [⬙ ⫹
mastos, breast, ⫹ itis, inflammation]
Inflammation of the fibrous tissue
around a breast.
perimeningitis (pĕr⬙ı̆-mĕn⬙ı̆n-jı̄⬘tı̆s) [Gr.
peri, around, ⫹ meninx, membrane,
⫹ itis, inflammation] Pachymeningitis.
perimenopause (pĕr-ē-mĕn⬘ō-păwz) The
phase prior to the onset of menopause
(known as the menopausal transition)
and the first year after menopause. It
includes three distinct elements: the
time during which menstrual cycles become increasingly less regular and follicle stimulating hormones rise; the last
menstrual period; and the first 12 consecutive months during which no menses occur.
perimeter (pĕr-ı̆m⬘ĕ-tĕr) [⬙ ⫹ metron,
measure] 1. The outer edge or periphery of a body or measure of the same.
2. A device for determining the extent of
the field of vision. SEE: perimetry.
perimetric (pĕr⬙ı̆-mĕt⬘rı̆k) [⬙ ⫹ metra,
uterus] Around the uterus.
perimetritic (pĕr⬙ı̆-mē-trı̆t⬘ı̆k) [⬙ ⫹ metra, uterus, ⫹ itis, inflammation]
Concerning perimetritis.
perimetritis (pĕr⬙ı̆-mē-trı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
itis, inflammation] Inflammation of the
peritoneal covering of the uterus; may
be associated with parametritis.
perimetrium (pĕr-ı̆-mē⬘trē-ŭm) The serous layer of the uterus.
perimetry (pĕr-ı̆m⬘ĕ-trē) [⬙ ⫹ metron,
measure] 1. Circumference; edge; border of a body. 2. Measurement of the
scope of the field of vision with a perimeter.
kinetic p. A test of visual field impairment in which a person’s ability to
see peripherally placed objects is assessed by moving the objects but keeping their size and brightness unchanged.
static p. A test of visual field impairment in which a person’s ability to see
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perimyelitis
perinephric
top of rh
base of rh
perinaion, perineum, ⫹ metron, measure] An apparatus for measuring the
pressure or force that is produced in the
vagina when the pubococcygeus and levator ani muscles are contracted voluntarily. SEE: Kegel exercise.
perineoplasty (pĕr⬙ı̆-nē⬘ō-plăs⬙tē) [⬙ ⫹
plassein, to form] Reparative surgery
on the perineum.
perineorrhaphy (pĕr⬙ı̆-nē-or⬘ă-fē) [⬙ ⫹
rhaphe, a sewing] Suture of the perineum to repair a laceration that occurs
or is made surgically during the delivery of the fetus.
PATIENT CARE: Caregivers should
implement standard precautions, wearing disposable gloves throughout perineal assessment, patient care, and disposal of biohazardous wastes, and
performing thorough hand hygiene before and after procedures. Assessments
focus on diet and fluid intake, bowel
elimination, and the status of the suture
line. To minimize potential for autoinfection, patient care and teaching
should emphasize cleansing the perineum from front to rear after urination
or defecation with a cascade of warm
fluid or an antiseptic towelette. Perineal
pads also should be applied and removed from front to rear. Application of
an ice pack immediately after delivery
and intermittently during the first 24 hr
postpartum aids in reducing edema and
relieving discomfort. To maximize effects, the ice pack should be removed 20
min after its placement and reapplied
10 min later and the mother taught this
20 min on, 10 min off regimen. The use
of warm Sitz baths for 20 min several
times daily is encouraged. Personal portable Sitz baths avoid the possibility of
cross-contamination and may be sent
home with the mother. Pain is assessed
and analgesics are administered as prescribed. Ambulation also is encouraged.
Gluteal splinting (i.e., tensing the buttocks while sitting or rising from a
seated position) reduces discomfort.
Health care professionals should provide support and reassurance because
the patient may experience anxiety
about the ability to resume normal
physical functions and sexual activity
and should provide opportunities for the
patient to express feelings and to ask
questions.
anterior p. Surgical repair of anterior perineum and vaginal wall to correct a cystocele.
posterior p. The removal and repair
of a rectocele.
perineoscrotal (pĕr⬙ı̆-nē-ō-skrō⬘tăl) [⬙ ⫹
L. scrotum, a bag] Concerning the perineum and scrotum.
perineotomy (pĕr⬙ı̆-nē-ŏt⬘ō-mē) [⬙ ⫹
tome, incision] Surgical incision into
the perineum. SYN: perineal section.
perinephric (pĕr⬙ı̆-nĕf⬘rı̆k) [Gr. peri,
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standard
1748
objects at the edges of the visual field is
assessed by changing the brightness or
size of the objects but not their position.
perimetric, adj.
perimyelitis (pĕr⬙ı̆-mı̄⬙ĕ-lı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
itis, inflammation] 1. Inflammation of
the pia mater and arachnoid of the
brain or spinal cord. SYN: leptomeningitis. 2. Inflammation of the endosteum
or membrane around medullary cavity
of a bone.
perimyelography
(pĕr⬙ı̆-mı̄⬙ĕ-lŏg⬘ră-fē)
[⬙ ⫹ ⬙ ⫹ graphein, to write] Radiological examination of the area around
the spinal cord.
perimyoendocarditis (pĕr⬙ı̆-mı̄⬙ō-ĕn⬙dōkăr-dı̄⬘tı̆s) [⬙ ⫹ mys, muscle, ⫹ endon, within, ⫹ kardia, heart, ⫹ itis,
inflammation] Inflammation of the
muscular wall of the heart, its endothelial lining, and the pericardium.
perimyolysis (pĕr⬙ē-mı̄⬙ō-lı̄⬘sı̆s) Loss of
enamel from the lingual surface of the
anterior teeth. A complication of repeated bouts of regurgitation (e.g., as in
bulimia nervosa). Another dental complication of bulimia is the development
of multiple dental caries.
perimyositis (pĕr⬙ı̆-mı̄⬙ō-sı̄⬘tı̆s) [⬙ ⫹ ⬙
⫹ itis, inflammation] Inflammation of
the connective tissue around a muscle.
perimysia (pĕr⬙ı̆-mı̆s⬘ē-ă) Pl. of perimysium.
perimysiitis (pĕr⬙ı̆-mı̆s⬙ē-ı̄⬘tı̆s) [⬙ ⫹
mys, muscle, ⫹ itis, inflammation]
Inflammation of the sheath surrounding a muscle.
perimysium (pĕr⬙ı̆-mı̆s⬘ē-ŭm) pl. perimysia A connective tissue sheath that envelops each primary bundle of muscle fibers; sometimes called perimysium
internum.
perinatal (pĕr⬙ı̆-nā⬘tăl) [Gr. peri, around,
⫹ L. natalis, birth] Concerning the period beginning after the 28th week of
pregnancy and ending 28 days after
birth.
perinatal programming The triggering of
illnesses in adults by events that occurred during development within the
womb.
perinatology
(pĕr-ē-nā-tŏl⬘ō-jē)
The
study of the fetus and infant during the
perinatal period. SEE: perinatal.
perineal (pĕr⬙ı̆-nē⬘ăl) [Gr. perinaion,
perineum] Concerning, or situated on,
the perineum.
perineal body A mass of tissue that separates the anus from the vestibule and
the lower part of the vagina.
perineo- [Gr. perinaion] Combining
form meaning perineum.
perineocele (pĕr⬙ı̆-nē⬘ō-sēl) [Gr. perinaion, perineum, ⫹ kele, tumor, swelling] A hernia in the region of the perineum, between the rectum and vagina
or between the rectum and prostate.
SYN: perineal hernia.
perineometer (pĕr⬙ı̆-nē-ŏm⬘ĕ-ter) [Gr.
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1749
perinephritis
around, ⫹ nephros, kidney] Located
or occurring around the kidney.
perinephritis (pĕr⬙ı̆-nĕ-frı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
itis, inflammation] Inflammation of
peritoneal tissues around the kidney.
perinephrium (pĕr⬙ı̆-nĕf⬘rē-ŭm) The connective and fatty tissue surrounding the
kidney. perinephrial, adj.
perineum (pĕr⬙ı̆-nē⬘ŭm) [Gr. perinaion]
1. The structures occupying the pelvic
outlet and constituting the pelvic floor.
2. The external region between the
vulva and anus in a female or between
the scrotum and anus in a male. It is
made up of skin, muscle, and fasciae.
The muscles of the perineum are the anterior portion of the intact levator ani
muscle and the transverse perineal
muscle. SEE: illus.; perineal body.
PREPUCE OF
CLITORIS
LABIA MAJORA
LABIA MINORA
CLITORIS
VESTIBULE OF
ANUS
URETHRAL
ENTRANCE TO
ORIFICE
HYMEN
VAGINA
VAGINAL
POSTERIOR
ORIFICE
LABIAL
COMMISSURE
PERINEUM
tears of the p. Laceration of the perineum during delivery. There are four
degrees of severity caused by overstretching of the vagina and perineum
during delivery. Fetal malposition increases the chance of tears occurring.
A first-degree tear involves superficial tissues of the perineum and vaginal
mucosa but does not injure muscular
tissue. A second-degree tear involves
those tissues included in a first-degree
tear and the muscles of the perineum
but not the muscles of the anal sphincter. A third-degree tear involves all of
the tissues of the second-degree tear
and the muscles of the anal sphincter. A
fourth-degree tear extends completely
through the perineal skin, vaginal mucosa, perineal body, anal sphincter muscles, and the rectal mucosa.
period
Complications include hemorrhage,
infection, cystocele, rectocele, descent of
uterus, and occasionally loss of bowel
control. Surgery is necessary to treat
this condition.
perineural
(pĕr⬙ı̆-nū⬘răl)
[Gr. peri,
around, ⫹ neuron, nerve] Around a
nerve.
perineurial (pĕr⬙ı̆-nū⬘rē-ăl) [⬙ ⫹ neuron, sinew] Concerning the perineurium, the sheath around a bundle of
nerve fibers.
perineuritis (pĕr⬙ı̆-nū-rı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
itis, inflammation] Inflammation of the
sheath enveloping nerve fibers.
perineurium (pĕr⬙ı̆-nū⬘rē-ŭm) [⬙ ⫹ neuron, sinew] A connective tissue sheath
investing a fasciculus or bundle of nerve
fibers.
perinuclear (pĕr⬙ı̆-nū⬘klē-ăr) [⬙ ⫹ L.
nucleus, a kernel] Around a nucleus.
periocular (pĕr⬙ē-ŏk⬘ū-lăr) [⬙ ⫹ L. oculus, eye] Located around the eye. SYN:
circumocular.
period (pēr-ē-ŭd) [L. periodus] 1. The
interval between two successive occurrences of any regularly recurring phenomenon or event; a cycle. 2. Colloquial
expression for the menstrual flow.
3. Time occupied by a disease in running its course, or by a stage of a disease, such as an incubation period.
absolute refractory p. Following
contraction of a muscle fiber or transmission of a nerve impulse by a neuron,
the period in which a stimulus, no matter how strong, will not elicit a response.
effective refractory p. In electrocardiography, the interval during which a
second action potential cannot occur in
an excitable fiber unless the stimulus is
much stronger than usual; the membrane is still in the repolarization phase
of the previous action potential.
isoelectric p. 1. In an occurrence
that normally produces an electric force,
such as a muscle contraction, the time
or point when no electrical energy is
produced. 2. In an electrocardiogram,
the period when the electrical tracing is
neither positive nor negative.
isometric p. Postsphygmic p.
postsphygmic p. The short period in
diastole when the ventricles are relaxed
and no blood is entering. This lasts until
the atrioventricular valves open. SYN:
isometric period.
presphygmic p. The short period in
systole beginning with closing of the
atrioventricular valves and ending with
opening of the valves connecting the
right and left ventricles to the pulmonary artery and aorta, respectively.
relative refractory p. The period after activation of a nerve or muscle, during recovery, when it can be excited only
by a stronger-than-normal stimulus.
silent p. 1. The time in the course of
a disease in which the signs and symp-
top of rh
base of rh
short
standard
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periodic
periodontitis
top of rh
base of rh
the teeth are anchored. The most common initial symptom is bleeding gums,
but loosening of the teeth, receding
gums, abscesses in pockets between the
gums and the teeth, and necrotizing ulcerative gingivitis may be present as the
disease process worsens. Proper dental
hygiene, including proper brushing of
the teeth, use of dental floss, gum massage, and periodic removal of plaque by
a dentist or dental hygienist, will help
to prevent periodontal disease.
TREATMENT: In the early stages of
the disease, curettage of the irritating
material— plaque and calculus (tartar)— from the crown and root surfaces
of the teeth may be the only treatment
required. In more advanced stages, procedures such as gingivectomy, gingivoplasty, and correction of the bony architecture of the teeth may be required.
Adjustment of the occlusion of the teeth
and orthodontic treatment may be used
in order to help prevent recurrences.
SEE: plaque; teeth; tooth; toothbrushing.
PATIENT CARE: Dental professionals
teach the patient about the importance
of proper dental care, including brushing for two minutes twice a day, flossing,
and regular dental examinations and
prophylaxis. Patients should consult a
dentist if recession of teeth from gums,
any drainage from gums, or bleeding
gums occur, because these symptoms
may indicate periodontal disease. The
patient may also need medical follow-up
to ascertain whether or not hypovitaminosis, blood dyscrasias, diabetes mellitus, or use of hormonal contraceptive
drugs are contributing to or causing the
dental problems.
p. pocket reduction Pocket reduction.
periodontal pocket SEE: under pocket.
periodontia
(pĕr⬙ē-ō-dŏn⬘shē-ă)
[Gr.
peri, around, ⫹ odous, tooth] 1. Plural of periodontium. 2. Periodontics.
periodontics (pĕr⬙ē-ō-dŏn⬘tı̆ks) [⬙ ⫹
odous, tooth] The branch of dentistry
dealing with treatment of diseases of
the supporting tissues of the teeth, the
periodontium. SYN: periodontia (2);
periodontology.
periodontitis (pĕr⬙ē-ō-dŏn-tı̄⬘tı̆s) [⬙ ⫹ ⬙
⫹ itis, inflammation] Inflammation or
degeneration, or both, of the dental periosteum, alveolar bone, cementum, and
adjacent gingiva. Suppuration usually
occurs, supporting bone is resorbed,
teeth become loose, and recession of gingivae occurs. This condition usually follows chronic gingivitis, Vincent’s infection, or poor dental hygiene. Systemic
factors may also predispose one to this
condition. SYN: Riggs’ disease. SEE: table.
aggressive p. ABBR: AgP. Periodontitis in which alveolar bone loss and
ligament failure occur rapidly, resulting
short
standard
1750
toms are so mild as to be difficult to detect. 2. A pause in normally continuous
electrical events such as an electrocardiogram (ECG) or electroencephalogram (EEG). 3. A period in a tendon reflex that immediately follows the
contraction of the responding muscles
during which the motor neurons do not
respond to afferent impulses entering
the reflex center.
periodic (pēr-ē-ŏd⬘ı̆k) [Gr. periodikos]
Recurring after definite intervals.
periodic abstinence A method of birth
control in which a couple tries to avoid
pregnancy by refraining from sexual intercourse during certain times within
the menstrual cycle.
periodic catatonia An inherited form of
schizophrenia characterized by psychomotor disturbances, including grimacing, stereotyped body movements, and
hyperkinetic movements alternating
with mutism, staring, and body posturing. Susceptibility to this condition has
been linked to genes on chromosome 15.
periodic health examination A health
screening examination performed on a
scheduled or routine basis. The appropriate features of this examination depend on the patient’s age, gender, and
sometimes health history, family history, or employment status. Adult
women, for example, should have periodic examinations, including Pap
smears and professional breast examinations, whereas professional pilots and
truckers are screened periodically for visual impairment and hypertension,
among other conditions. All adults over
age 45 should be screened for diabetes
mellitus. Patients with a personal history of cancer may be screened periodically for evidence of disease recurrence.
For many patients, the periodic examination may include blood tests (e.g., to
check levels of cholesterol and other lipids), immunological tests (e.g., health
care workers are periodically screened
for tuberculosis), or invasive examinations (e.g., sigmoidoscopy or colonoscopy
to look for colon cancer). SEE: mammography; Papanicolaou test; table under
cancer.
periodicity (pēr⬙ē-ō-dı̆s⬘ı̆-tē) 1. The state
of being regularly recurrent. 2. The rate
of rise and fall or interruption of a unidirectional current in physical therapy.
periodic leg movements in sleep ABBR:
PLMS. Jerking or twitching of the toes,
ankles, knees, or hips during sleep.
periodic table A chart with the chemical
elements arranged by their atomic numbers. SEE: law, periodic.
periodontal (pĕr⬙ē-ō-dŏn⬘tăl) [Gr. peri,
around, ⫹ odous, tooth] Located
around a tooth. SYN: peridental.
p. disease A disease of the supporting structures of the teeth, the periodontium, including alveolar bone to which
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periodontitis
1751
Symptoms and Signs
of Periodontitis
● Gums bleed during brushing or
flossing
● Gums are puffy or swollen
● Gums have a bright red appearance
● Gum line has receded, giving the
teeth a longer appearance
● Bad breath persists even after
brushing and flossing
in dental mobility and sometimes exfoliation (loss of teeth). The disease often
begins in adolescence and may cluster
in families. SYN: rapidly progressive
periodontitis.
apical p. Periodontitis of the periapical region usually leading to formation
of periapical abscess.
chronic p. Periodontitis in which
there is gradual and persistent evidence
of periodontal pocket formation, injury
to the ligamentous attachments of the
teeth, alveolar bone destruction, and
eventually, dental loosening.
early p. Periodontitis in which, despite mild-to-moderate pocket formation and some bone loss, there is no evidence of abnormal tooth movement.
moderate p. Periodontitis in which
moderate bone loss and pocket formation are accompanied by abnormal tooth
mobility.
rapidly progressive p. Aggressive
periodontitis.
periodontium (pĕr-ē-ō-dŏn⬘shē-ŭm) The
structures that support the teeth, cushion the shock of chewing, and keep the
teeth firmly anchored in the bone. These
structures are the gingivae, periodontal
membrane or ligament, cementum, and
alveolar bone.
periodontoclasia (pĕr⬙ē-ō-dŏn⬙tō-klā⬘zē-ă)
[⬙ ⫹ odous, tooth, ⫹ klasis, breaking]
A condition characterized by inflammation accompanied by degenerative and
retrogressive changes in the periodontium. SYN: peridentitis.
periodontology (pĕr⬙ē-ō-dŏn-tŏl⬘ō-jē) [⬙
⫹ ⬙ ⫹ logos, word, reason] Periodontics.
periodontosis (pĕr⬙ē-ō-dŏn-tō⬘sı̆s) [⬙ ⫹
⬙ ⫹ osis, condition] Any degenerative
disease of the periodontal tissues.
periodoscope (pĕr⬙ē-ōd⬘ō-skōp) [LL. periodus, interval of time, ⫹ skopein, to
examine] A table or dial for the calculation of the expected date of delivery.
SEE: pregnancy for table.
period of reactivity In obstetrics, an initial episode of activity, alertness, and
responsiveness to interaction, characteristic of the physiological and social
responses of newborns to stimuli. The
first period of reactivity begins with
birth, lasts approx. 30 min, and ends
periosteoma
when the infant falls into a deep sleep.
Common assessment findings include
transient tachypnea, nasal flaring, sternal retraction, crackles, tachycardia,
and irregular heart rhythms. The second period of reactivity begins when the
infant awakens and usually lasts 4 to 6
hr. Common assessment findings include signs of excessive respiratory and
gastric mucus, hunger, apneic episodes,
and the passing of a meconium stool.
periomphalic (pĕr⬙ē-ŏm-făl⬘ı̆k) [Gr. peri,
around, ⫹ omphalos, navel] Located
around or near the umbilicus.
perionychia (pĕr⬙ē-ō-nı̆k⬘ē-ă) [⬙ ⫹ onyx,
nail] Inflammation around a nail.
perionychium (pĕr⬙ē-ō-nı̆k⬘ē-ŭm) The
epidermis surrounding a nail.
perionyx (pĕr⬙ē-ō⬘nı̆ks) [⬙ ⫹ onyx, nail]
The remnant of the eponychium that
persists as a band across the root of the
nail.
perionyxis (pĕr⬙ē-ō-nı̆k⬘sı̆s) Inflammation of the epidermis surrounding a nail.
perioophoritis (pĕr⬙ē-ō-ŏf⬙ō-rı̄⬘tı̆s) [⬙ ⫹
oophoron, ovary, ⫹ itis, inflammation]
Inflammation of the surface membrane
of the ovary. SYN: perioothecitis.
perioophorosalpingitis (pĕr⬙ē-ō-ŏf⬙ō-rōsăl⬙pı̆n-jı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹ salpinx, tube,
⫹ itis, inflammation] Inflammation of
the tissues around an ovary and oviduct. SYN: perioothecosalpingitis.
perioothecitis (pĕr⬙ē-ō⬙ō-thē-sı̄⬘tı̆s) [⬙ ⫹
oon, egg, ⫹ theke, box, ⫹ itis, inflammation] Perioophoritis.
perioothecosalpingitis (pĕr⬙ē-ō⬙ō-thē⬙kōsăl-pı̆n-jı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹ ⬙ ⫹ salpinx,
tube, ⫹ itis, inflammation] Periophorosalpingitis.
perioperative (pĕr-ē-ŏp⬘ĕr-ă-tı̆v) Occurring in the period immediately before,
during, and/or after surgery.
perioperative period The time immediately before, during, and after surgery.
perioral (pĕr⬙ē-or⬘ăl) [⬙ ⫹ L. oralis,
mouth] Surrounding the mouth. SYN:
circumoral.
periorbita (pĕr⬙ē-or⬘bı̆-tă) [⬙ ⫹ L. orbita, orbit] Connective tissue lining the
socket of the eye.
periorbital (pĕr⬙ē-or⬘bı̆-tăl) Surrounding
the socket of the eye. SYN: circumorbital.
periorbititis (pĕr⬙ē-or⬙bı̆-tı̄⬘tı̆s) [⬙ ⫹ L.
orbita, orbit, ⫹ Gr. itis, inflammation]
Inflammation of the periorbita.
periorchitis (pĕr⬙ē-or-kı̄⬘tı̆s) [⬙ ⫹ orchis, testicle, ⫹ itis, inflammation]
Inflammation of the tissues investing a
testicle.
p. hemorrhagica A chronic hematocele of the tunica vaginalis of the testis.
periosteitis (pĕr⬙ē-ŏs⬙tē-ı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
itis, inflammation] Periostitis.
periosteoma (pĕr⬙ē-ŏs-tē-ō⬘mă) [⬙ ⫹ ⬙
⫹ oma, tumor] 1. An abnormal growth
surrounding a bone. 2. A tumor of the
top of rh
base of rh
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
periosteomyelitis
1752
periosteum, the tissue surrounding a
bone.
periosteomyelitis (pĕr⬙ē-ŏs⬙tē-ō-mı̄⬙ĕ-lı̄⬘
tı̆s) [⬙ ⫹ ⬙ ⫹ myelos, marrow, ⫹
itis, inflammation] Inflammation of
bone, including the periosteum and
marrow. SYN: periostomedullitis.
periosteophyte (pĕr⬙ē-ŏs⬘tē-ō-fı̄t) [⬙ ⫹
osteon, bone, ⫹ phyton, growth] An
abnormal bony growth on the periosteum, or arising from it.
periosteorrhaphy (pĕr⬙ē-ŏs⬙tē-or⬘ă-fē) [⬙
⫹ ⬙ ⫹ rhaphe, seam, ridge] Joining
by suture the margins of a severed periosteum.
periosteotome (pĕr⬙ē-ŏs⬘tē-ō-tōm) [⬙ ⫹
osteon, bone, ⫹ tome, incision] An instrument for cutting the periosteum or
removing it from the bone.
periosteotomy (pĕr⬙ē-ŏs-tē-ŏt⬘ō-mē) Incision into the periosteum.
periosteum (pĕr-ē-ŏs⬘tē-ŭm ) [Gr. periosteon ] The fibrous membrane that
forms the covering of bones except at
their articular surfaces; consists of a
dense external layer containing numerous blood vessels and an inner layer of
connective tissue cells that function as
osteoblasts when the bone is injured
and then participate in new bone formation. Periosteum serves as a supporting structure for blood vessels nourishing bone and for attachment of
tendons and ligaments.
alveolar p. Periodontal ligament.
p. externum Periosteum covering external surfaces of bones.
p. internum Interior periosteum lining the marrow canal of a bone.
periostitis (pĕr⬙ē-ŏs-tı̄⬘tı̆s) [⬙ ⫹ itis, inflammation] Inflammation of the periosteum, the membrane covering a bone.
Findings include pain over the affected
part, esp. under pressure; fever; sweats;
leukocytosis; skin inflammation, and rigidity of overlying muscles. Infectious
diseases, esp. syphilis, and trauma
cause this condition. SYN: periosteitis.
albuminous p. Periostitis with albuminous serous fluid exudate beneath
the membrane affected.
alveolar p. Periodontitis.
diffuse p. Periostitis of the long
bones.
hemorrhagic p. Periostitis with extravasation of blood under the periosteum.
periostoma (pĕr⬙ē-ŏs-tō⬘mă) [Gr. peri,
around, ⫹ osteon, bone, ⫹ oma, tumor] A bony neoplasm around a bone
or arising from its membranous sheath.
periostomedullitis (pĕr⬙ē-ŏs⬙tō-mĕd-ū-lı̄⬘
tı̆s) [⬙ ⫹ ⬙ ⫹ L. medulla, marrow, ⫹
Gr. itis, inflammation] Periosteomyelitis.
periostosis (pĕr⬙ē-ŏs-tō⬘sı̆s) [⬙ ⫹ ⬙ ⫹
osis, condition] A bony neoplasm
around a bone or arising from it.
periostosteitis (pĕr⬙ē-ŏs-tŏs⬙tē-ı̄⬘tı̆s) [⬙
peripheral vascular disease
top of rh
base of rh
⫹ ⬙ ⫹ osteon, bone, ⫹ itis, inflammation] Osteoperiostitis.
periostotome (pĕr⬙ē-ŏs⬘tō-tōm) [⬙ ⫹ ⬙
⫹ tome, incision] Periosteotome.
periostotomy (pĕr⬙ē-ŏs-tŏt⬘ō-mē) [⬙ ⫹ ⬙
⫹ tome, incision] Periosteotomy.
periotic (pĕr-ē-ō⬘tı̆k) [⬙ ⫹ ous, ear] Situated around the ear, esp. the internal
ear.
periovular (pĕr⬙ē-ō⬘vū-lăr) [⬙ ⫹ L.
ovulum, little egg] Around an ovum.
peripachymeningitis
(pĕr⬙ı̆-pak⬙ēmĕn⬙ı̆n-jı̄⬘tı̆s) [⬙ ⫹ pachys, thick, ⫹
meninx, membrane, ⫹ itis, inflammation] Inflammation of the connective
tissue between the dura mater and the
bone that encloses the central nervous
system.
peripancreatitis
(pĕr⬙ı̆-păn⬙krē-ă-tı̄⬘tı̆s)
[⬙ ⫹ pankreas, pancreas, ⫹ itis, inflammation] Inflammation of the tissues around the pancreas.
peripatetic (pĕr⬙ı̆-pă-tĕt⬘ı̆k) [L. peripateticus, to walk about while teaching]
Moving from place to place.
peripersonal (pĕr⬙ı̆-pŭr⬘sŭn-ı̆l) Near the
body; within arm’s reach.
periphacitis
(pĕr-ı̆-fă-sı̄⬘tı̆s)
[⬙
⫹
phakos, lens, ⫹ itis, inflammation]
Inflammation of the capsule of the lens
of the eye.
peripherad (pĕr-ı̆f⬘ĕr-ăd) [⬙ ⫹ pherein,
to bear, ⫹ L. ad, to] In the direction
of the periphery.
peripheral (pĕr-ı̆f⬘ĕr-ăl) Located at, or
pert. to, the periphery; occurring away
from the center.
peripheral arterial disease ABBR: PAD.
Atherosclerotic disease of the aortoiliac,
axillary, carotid, or femoral arteries. It
affects more than 8 million Americans,
many of whom also have ischemic disease of the coronary arteries or a history
of heart attack or stroke. PAD contributes to claudication, amputation,
stroke, and other diseases and conditions. SEE: peripheral vascular disease.
peripheral nervous system ABBR: PNS.
The portion of the nervous system outside the central nervous system: the 12
pairs of cranial nerves and 31 pairs of
spinal nerves. These nerves contain
sensory and somatic motor fibers and
the motor fibers of the autonomic nervous system.
peripheral neurovascular dysfunction,
risk for A state for which an individual
is at risk of experiencing a disruption in
circulation, sensation, or motion of an
extremity. SEE: Nursing Diagnoses Appendix.
peripheral vascular disease ABBR: PVD.
Any condition that causes partial or
complete obstruction of the flow of blood
to or from the arteries or veins outside
the chest. Peripheral vascular disease
includes atherosclerosis of the carotid,
aortoiliac, femoral, and axillary arteries, as well as deep venous thrombo-
short
standard
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peripheral zone of the prostate
1753
ses of the limbs, pelvis, and vena cava.
SEE: atherosclerosis; claudication; deep
venous thrombosis; Nursing Diagnoses
Appendix.
peripheral zone of the prostate The lateral border of the prostate gland. Most
prostate cancers begin here.
periphery (pĕr-ı̆f⬘ĕ-rē) [Gr. periphereia]
The outer part or surface of a body; the
part away from the center.
periphlebitis (pĕr⬙ı̆-flĕ-bı̄⬘tı̆s) [Gr. peri,
around, ⫹ phleps, vein, ⫹ itis, inflammation] Inflammation of the external coat of a vein or tissues around it.
Periplaneta (pĕr⬙ı̆-plă-nē⬘tă) A genus of
cockroaches belonging to the order Orthoptera. Roaches contaminate food by
mechanically transporting disease-producing bacteria, ova, and protozoa to the
food.
P. americana The scientific name for
the American cockroach. Domestic infestations by P. americana may spread
disease to humans by defecating on food
or trigger asthma and other allergic reactions in susceptible people. Allergens
derived from this cockroach are abbreviated Per a by the World Health Organization.
P. australasiae The Australian cockroach.
peripleural (pĕr⬙ı̆-plū⬘răl) [⬙ ⫹ pleura,
rib] Encircling the pleura.
peripleuritis (pĕr-ı̆-plū-rı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
itis, inflammation] Inflammation of the
connective tissues between the pleura
and wall of the chest.
peripolar (pĕr⬙ı̆-pō⬘lăr) [⬙ ⫹ L. polus,
pole] Around a pole.
peripolesis (pĕr⬙ı̆-pō-lē⬘sı̆s) [Gr., a going
about] In tissue culture, the collecting
of lymphocytes around macrophages.
periporitis (pĕr⬙ı̆-por-ı̄⬘tı̆s) [Gr. peri,
around, ⫹ L. porus, pore, ⫹ Gr. itis]
Multiple abscesses around sweat
glands, esp. as a complication of malaria
in children.
periportal tracking In the evaluation of
patients with abdominal injuries, the
finding of decreased computerized tomographic attenuation around the portal region of the liver. This should be
presumed to represent bleeding, which
may require operative intervention.
periproctic (pĕr⬙ı̆-prŏk⬘tı̆k) [⬙ ⫹ proktos, anus] Around the anus and rectum.
periproctitis (pĕr⬙ı̆-prŏk-tı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
itis, inflammation] Inflammation of the
areolar tissues in the region of the rectum and anus. SYN: perirectitis.
periprostatitis (pĕr⬙ı̆-prŏs-tă-tı̄⬘tı̆s) [⬙ ⫹
⬙ ⫹ itis, inflammation] Inflammation
of the tissues surrounding the prostate.
peripylephlebitis (pĕr⬙ı̆-pı̄⬙lē-flĕ-bı̄⬘tı̆s) [⬙
⫹ pyle, gate, ⫹ phlebos, vein, ⫹ itis,
inflammation] Inflammation of tissues
about the portal vein.
peripyloric (pĕr⬙ı̆-pı̄-lor⬘ı̆k) [⬙ ⫹ pylo-
peristalsis
ros, pylorus] Extending around the pylorus.
periradicular (pĕr-ē-ră-dı̆k⬘ū-lăr) Around a
root or a rootlike process, esp. relating
to a tooth.
perirectal (pĕr⬙ı̆-rĕk⬘tăl) [⬙ ⫹ L. rectus,
straight] Extending around the rectum.
perirectitis (pĕr⬙ı̆-rĕk-tı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
Gr. itis, inflammation] Periproctitis.
perirenal (pĕr⬙ı̆-rē⬘năl) [⬙ ⫹ L. ren, kidney] Extending around the kidney.
SYN: perinephric.
perirhizoclasia (pĕr⬙ı̆-rı̄⬙zō-klā⬘zē-ă) [⬙
⫹ rhiza, root, ⫹ klasis, destruction]
Inflammation and destruction of tissues
extending around the roots of a tooth.
perisalpingitis (pĕr⬙ı̆-săl⬙pı̆n-jı̄⬘tı̆s) [⬙ ⫹
salpinx, tube, ⫹ itis, inflammation]
Inflammation of the peritoneum on the
surface of the fallopian tube, usually as
a result of a sexually transmitted infection or endometriosis.
perisalpinx (pĕr⬙ı̆-săl⬘pı̆nks) [⬙ ⫹ salpinx, tube] The peritoneum covering
the upper borders of the uterine tubes.
periscopic (pĕr⬙ı̆-skŏp⬘ı̆k) [⬙ ⫹ skopein,
to examine] Viewing on all sides; providing a wide range of vision.
perisigmoiditis
(pĕr⬙ı̆-sı̆g⬙moy-dı̄⬘tı̆s)
[Gr. peri, around, ⫹ sigma, Gr. letter
S, ⫹ eidos, form, shape, ⫹ itis, inflammation] Inflammation of peritoneal tissues around the sigmoid colon.
perisinusitis (pĕr⬙ı̆-sı̄⬙nŭ-sı̄⬘tı̆s) [⬙ ⫹ L.
sinus, cavity, ⫹ Gr. itis, inflammation]
Inflammation of membranes about a sinus, esp. a venous sinus of the dura mater.
perispermatitis (pĕr⬙ı̆-spĕr⬙mă-tı̄⬘tı̆s) [⬙
⫹ sperma, seed, ⫹ itis, inflammation]
Inflammation of tissues about the spermatic cord.
p. serosa Hydrocele of the spermatic
cord.
perisplanchnitis (pĕr⬙ı̆-splănk-nı̄⬘tı̆s) [⬙
⫹ ⬙ ⫹ itis, inflammation] Perivisceritis.
perisplenic (pĕr⬙ı̆-splĕn⬘ı̆k) [⬙ ⫹ splen,
spleen] Near or around the spleen.
perisplenitis (pĕr⬙ı̆-splĕ-nı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
itis, inflammation] Inflammation of the
peritoneal coat of the spleen, the splenic
capsule.
perispondylitis (pĕr⬙ı̆-spŏn-dı̆l-ı̄⬘tı̆s) [⬙
⫹ ⬙ ⫹ itis, inflammation] Inflammation of the parts around a vertebra.
peristalsis (pĕr-ı̆-stăl⬘sı̆s) [Gr. peri,
around, ⫹ stalsis, contraction] A progressive wavelike movement that occurs involuntarily in hollow tubes of the
body, esp. the alimentary canal. It is
characteristic of tubes possessing longitudinal and circular layers of smooth
muscle fibers.
Peristalsis is induced reflexly by distention of the walls of the tube. The
wave consists of contraction of the circular muscle above the distention with
top of rh
base of rh
short
standard
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peritoneoscope
top of rh
base of rh
capsule or tissues sheathing the thyroid
gland. SYN: peristrumitis.
peritomy (pĕr-ı̆t⬘ō-mē) [⬙ ⫹ tome, incision] 1. A 360⬚ incision of the conjuctiva
and subconjuctival tissue around the
limbus as part of retinal surgery or enucleation. SYN: syndectomy. 2. Circumcision.
peritoneal (pĕr⬙ı̆-tō-nē⬘ăl) [Gr. peritonaion, peritoneum] Concerning the
peritoneum.
p. fluid The clear straw-colored serous fluid secreted by the cells of the
peritoneum. The few milliliters present
in the peritoneal cavity moisten the surfaces of the two peritoneal layers and allow them to glide over each other as the
intestinal tract changes shape during
the process of digestion and absorption.
In certain disease states (such as rightsided heart failure, cirrhosis, or ovarian
malignancy) the amount of peritoneal
fluid is increased. SEE: illus.; ascites.
peritonealize (pĕr-ē-tōn⬘ē-ă-lı̄z) During
abdominal surgery, to cover a tissue
with peritoneum.
peritoneo- Combining form meaning
peritoneum.
peritoneocentesis (pĕr⬙ı̆-tō⬙nē-ō-sĕn-tē⬘
sı̆s) [Gr. peritonaion, peritoneum, ⫹
kentesis, puncture] Piercing of the peritoneal cavity to obtain fluid. SEE: paracentesis.
peritoneoclysis (pĕr⬙ı̆-tō⬙nē-ō-klı̄⬘sı̆s) [⬙
⫹ klysis, a washing out] Introduction
of fluid into the peritoneal cavity.
peritoneopexy
(pĕr⬙ı̆-tō⬘nē-ō-pĕks⬙ē)
[Gr. peritonaion, peritoneum, ⫹ pexis,
fixation] Fixation of the uterus via the
vagina.
peritoneoplasty (per⬙ı̆-tō⬘nē-ō-plăs⬙tē) [⬙
⫹ plassein, to form] Surgery to repair
separated or denuded segments of the
peritoneum.
peritoneoscope
(pĕr⬙ı̆-tō⬘nē-ō-skōp⬙)
[Gr. peritonaion, peritoneum, ⫹ skopein, to examine] A long, slender periscope or telescope device with a light at
one end and an eyepiece at the other;
used to inspect the peritoneal and ab-
short
standard
1754
peristalsis
POSTERIOR PLEURAL
SPACE
PELVIC CAVITY
PERITONEAL AND PLEURAL FLUID
relaxation of the region immediately
distal to the distended portion. The simultaneous contraction and relaxation
progresses slowly for a short distance as
a wave that causes the contents of the
tube to be forced onward.
mass p. Forceful peristaltic movements of short duration in which contents are moved from one section of the
colon to another, occurring three or four
times daily.
reverse p. Peristalsis in a direction
opposite to the normal direction. SYN:
antiperistalsis.
peristasis (pĕr-rı̆s⬘tă-sı̆s) [⬙ ⫹ stasis,
standing] 1. In the early stage of inflammation, the decrease in blood flow
in the affected area. 2. Environment.
peristomatous (pĕr⬙ı̆-stŏm⬘ă-tŭs) [⬙ ⫹
stoma, mouth] Around the mouth.
peristome (pĕr⬘ı̆-stōm) [⬙ ⫹ stoma,
mouth] The channel leading to the cytosome or mouth in certain types of protozoa.
peristrumitis (pĕr⬙ı̆-stroo-mı̄⬘tı̆s) [⬙ ⫹
L. struma, goiter, ⫹ itis, inflammation] Perithyroiditis.
peristrumous (pĕr⬙ı̆-stroo⬘mŭs) [⬙ ⫹ L.
struma, goiter] Around a goiter.
peritectomy (pĕr⬙ı̆-tĕk⬘tō-mē) [⬙ ⫹ ektome, excision] Surgical removal of a
ring of conjunctiva around the cornea.
peritendinitis,
peritenonitis
(pĕr⬙ı̆tĕn⬙dı̆-nı̄⬘tı̆s, −tĕn⬙ō-nı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
Gr. itis, inflammation] Tenosynovitis.
p. calcarea Calcific tendinitis.
p. serosa Peritendinitis with effusion into the sheath.
peritenon (pĕr⬙ı̆-tē⬘nŏn) [⬙ ⫹ tenon,
tendon] The sheath of a tendon.
perithelioma (pĕr⬙ı̆-thē-lē-ō⬘mă) [⬙ ⫹
thele, nipple, ⫹ oma, tumor] A tumor
derived from the perithelial layer of the
blood vessels.
perithelium (pĕr⬙ı̆-thē⬘lē-ŭm) The fibrous outer layer of the smaller blood
vessels.
perithyroiditis (pĕr⬙ı̆-thı̄-roy-dı̄⬘tı̆s) [⬙ ⫹
thyreos, shield, ⫹ eidos, form, shape,
⫹ itis, inflammation] Inflammation of
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peritoneoscopy
1755
dominal cavities through a small incision in the abdominal wall. SYN: laparoscope.
peritoneoscopy
(pĕr⬙ı̆-tō⬙nē-ŏs⬘kō-pē)
Examination of the peritoneal cavity
with a laparoscope.
peritoneotomy
(pĕr⬙ı̆-tō⬙nē-ŏt⬘ō-mē)
The process of incising the peritoneum.
peritoneum (pĕr⬙ı̆-tō-nē⬘ŭm) [LL., Gr.
peritonaion] The serous membrane lining the abdominal cavity and reflected
over the viscera.
EXAMINATION: Diseases that affect
the peritoneum can be assessed with
gentle and careful percussion and palpation of the abdomen. Localized or diffuse peritonitis, for example, may be
evident when the abdomen is tapped
with a percussing finger (the patient
will wince, guard the abdomen, and
complain that the percussion is very
painful); it may also be evident when
the abdominal wall is gently depressed
and then released (release of the examining hand causes guarding and discomfort). Fluid within the peritoneum (ascites) may be suggested by shifting
dullness on percussion of the abdominal
wall, or by the detection of a fluid wave
when one hand depresses and releases
on one side of the abdomen, while the
other hand gently holds the opposite
side. SEE: illus.
PERITONEUM
Seen laparoscopically (mag. ⫻1⁄2)
parietal p. Peritoneum lining the abdominal walls and the undersurface of
the diaphragm.
visceral p. Peritoneum that invests
the abdominal organs. The peritoneum
holds the viscera in place by its folds,
which are called the mesentery.
peritonism (pĕr⬘ı̆-tō-nı̆zm) [Gr. peritonaion, peritoneum, ⫹ −ismos, condition] 1. A condition having the clinical
signs of shock and peritonitis. 2. Symptoms similar to peritonitis, but without
actual inflammatory process, due instead to functional disease.
peritonitic (pĕr⬙ı̆-tō-nı̆t⬘ı̆k) [⬙ ⫹ itis, inflammation] Affected with or concerning peritonitis.
peritonitis (pĕr⬙ı̆-tă-nı̄⬘tı̆s) [⬙ ⫹ ⬙] In-
peritonitis
flammation of the serous membrane
that lines the abdominal cavity and its
viscera. SEE: chemical p.; primary p.;
secondary p.
ETIOLOGY: Peritonitis is caused by
infection of the abdominal cavity without obvious organ rupture (primary
peritonitis), by perforation (rupture) of
one of the internal organs (secondary
peritonitis), or by instillation of a
chemical irritant into the abdominal
cavity (chemical peritonitis).
Primary peritonitis occurs in patients
with cirrhosis and ascites, in some patients with tuberculosis (esp. those with
AIDS), and in patients who use the peritoneum for dialysis. Cirrhotic patients
develop peritonitis from infection of the
peritoneal contents by microorganisms
such as Streptococcus pneumoniae, enterococci, or Escherichia coli. Patients
who use the peritoneum for dialysis
(chronic ambulatory peritoneal dialysis
patients) sometimes contaminate their
dialysate with hand-borne microbes
such as staphylococci or streptococci. Dialysis patients may also develop peritonitis after the infusion of irritating
substances (e.g., antibiotics like vancomycin) into the peritoneal cavity during
treatment for these infections.
Common causes of secondary peritonitis are ruptured appendix, perforated
ulcer, abdominal trauma, and Crohn’s
disease. The gases, acids, fecal material,
and bacteria in the ruptured organs
spill into and inflame the peritoneum.
SYMPTOMS: Primary peritonitis is
marked by moderate to mild abdominal
pain, fever, change in bowel habits, and
malaise. Dialysis patients may notice
clouding of their discharged dialysate.
Fever, weight loss, inanition, and other
systemic symptoms are common in tuberculous peritonitis.
Secondary peritonitis is marked by
intense, constant abdominal pain that
worsens on body movement. It is often
associated with nausea, loss of appetite,
and fever or hypothermia. On examination the abdomen is typically distended and quiet, and the patient holds
very still in order to limit discomfort.
DIAGNOSIS: In patients with organ
rupture, a plain x-ray examination of
the abdomen may reveal air trapped beneath the diaphragm. Ultrasonography
or abdominal computed tomography is
used to visualize intraperitoneal fluid,
abscesses, and diseased organs. Paracentesis or peritoneal lavage are also
helpful in the diagnosis of some cases.
TREATMENT: Primary peritonitis
may respond to the administration of
antibiotics or antitubercular drugs, but
the prognosis is guarded. As many as
50% of affected patients may die of sepsis. Secondary peritonitis is treated
with surgical drainage, repair or re-
top of rh
base of rh
short
standard
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peritonitis
perivasculitis
top of rh
base of rh
secondary p. Peritonitis resulting
from extension of infection from adjoining structures, rupture of a viscus, abscess, or trauma.
septic p. Peritonitis caused by a pyogenic bacterium.
serous p. Peritonitis in which there
is copious liquid exudation.
silent p. Peritonitis in which there
are no signs or symptoms.
talc p. Peritonitis due to particles of
talcum powder in the peritoneal cavity
(e.g., postoperatively).
traumatic p. Acute peritonitis due to
injury or wound infection.
tuberculous p. Peritonitis caused by
tuberculosis.
peritonsillar (pĕr⬙ı̆-tŏn⬘sı̆-lăr) [Gr. peri,
around, ⫹ L. tonsilla, tonsil] Extending around a tonsil.
peritonsillitis (pĕr⬙ı̆-tŏn⬙sı̆-lı̄⬘tı̆s) [⬙ ⫹ ⬙
⫹ Gr. itis, inflammation] Inflammation of tissues around the tonsils.
peritrichal, peritrichic
(pĕ-rı̆t⬘rı̆-kăl,
pĕr⬙ē-trı̆k⬘ı̆k) [⬙ ⫹ thrix, hair] Peritrichous.
peritrichous (pĕ-rı̆t⬘rı̆k-ŭs) [⬙ ⫹ thrix,
hair] Indicating microorganisms that
have cilia or flagella covering the entire
surface of the cell. SYN: peritrichal.
perityphlitis (pĕr⬙ı̆-tı̆f-lı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
itis, inflammation] Inflammation about
the cecum; can be secondary to appendicitis.
periumbilical (pĕr⬙ē-ŭm-bı̆l⬘ı̆-kăl) [⬙ ⫹
L. umbilicus, a pit] Located around or
near the navel (i.e., umbilicus). SYN:
paraumbilical.
periungual (pĕr⬙ē-ŭng⬘gwăl) [⬙ ⫹ L.
unguis, nail] Around a nail.
periureteritis (pĕr⬙ē-ū-rē⬙tĕr-ı̄⬘tı̆s) [⬙ ⫹
⬙ ⫹ itis, inflammation] Inflammation
of parts around the ureter.
periurethral (pĕr⬙ē-ū-rē⬘thrăl) [⬙ ⫹ ourethra, urethra] Located around the
urethra.
periurethral bulking The injection of collagen, plastic polymers, or other substances around the bladder sphincter. It
is used as a surgical treatment for stress
urinary incontinence. Also known as
urethral bulking.
periurethritis (pĕr⬙ē-ū⬙rē-thrı̄⬘tı̆s) [⬙ ⫹
⬙ ⫹ itis, inflammation] Inflammation
of the tissues around the urethra.
periuterine (pĕr⬙ē-ū⬘tĕr-ı̆n) [⬙ ⫹ L.
uterus, womb] Around the uterus.
SYN: perimetric.
perivaginal (pĕr⬙ı̆-văj⬘ı̆-năl) [⬙ ⫹ L. vagina, sheath] Around the vagina.
perivaginitis (pĕr⬙ı̆-văj⬙ı̆-nı̄⬘tı̆s) [⬙ ⫹ ⬙
⫹ Gr. itis, inflammation] Inflammation of the region around the vagina.
SYN: pericolpitis.
perivascular (pĕr⬙ı̆-văs⬘kū-lăr) [⬙ ⫹ L.
vasculus, a little vessel] Around a vessel, esp. a blood vessel.
perivasculitis (pĕr⬙ı̆-văs⬙kū-lı̄⬘tı̆s) [⬙ ⫹ ⬙
⫹ Gr. itis, inflammation] Inflamma-
short
standard
1756
moval of the ruptured viscus, fluid resuscitation, and antibiotics. The prognosis depends on the patient’s
underlying condition, the rapidity of the
diagnosis and of subsequent medical intervention, and the skill of the surgeon.
acute diffuse p. Diffuse peritonitis.
adhesive p. Peritonitis in which the
visceral and parietal layers stick together.
aseptic p. Peritonitis due to causes
other than bacterial, fungal, or viral infection (e.g., trauma, presence of chemicals produced naturally or introduced
into the cavity, or irradiation).
bile p. Peritonitis caused by the escape of bile into the peritoneal cavity. It
usually results from an injury to the
gallbladder or biliary ducts during cholecystectomy.
chemical p. Peritonitis due to presence of chemicals (e.g., intestinal juices,
pancreatic secretions, or bile) in the
peritoneal cavity.
chronic p. Peritonitis usually caused
by tuberculosis or cancer. Findings include slight or absent fever, pain, diffuse tenderness, anemia, and emaciation.
circumscribed p. Localized p.
p. deformans Chronic peritonitis
with a thickened membrane and adhesions that contract and cause retraction
of the intestines.
diaphragmatic p. Peritonitis in
which the peritoneal surface of the diaphragm is mainly affected.
diffuse p. Peritonitis that is widespread, involving most of the peritoneum. SYN: generalized peritonitis.
fibrocaseous p. Peritonitis with fibrosis and caseation, usually caused by
tuberculosis.
gas p. 1. Peritonitis in which gas is
present in the peritoneal cavity.
2. Peritonitis caused by group A streptococci (GAS).
generalized p. Diffuse p.
localized p. Peritonitis confined to
the area immediately surrounding an
abscess, inflamed organ, or leak. SYN:
circumscribed peritonitis.
meconium p. Peritonitis in the newborn caused by perforation of the gastrointestinal tract in utero. It most often
occurs in newborns with cystic fibrosis.
Neonatal intestinal obstruction is also
usually present.
pelvic p. Peritonitis involving the
peritoneum of the pelvis, usually as a
result of endometrial, tubal, or ovarian
infections.
periodic p. Familial Mediterranean
fever.
primary p. Peritonitis resulting from
infectious
organisms
transmitted
through blood or lymph.
puerperal p. Peritonitis that develops after childbirth.
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periventricular
1757
tion of the tissues surrounding a blood
vessel. SYN: periangiitis.
periventricular
(pĕr⬙ı̆-vĕn-trı̆k⬘ū-lăr)
Pert. to the area surrounding or near
the ventricles, esp. the ventricles of the
brain.
perivertebral (pĕr⬙ı̆-vĕr⬘tĕ-brăl) [⬙ ⫹ L.
vertebra, vertebra] Around a vertebra.
perivesical (pĕr⬙ı̆-vĕs⬘ı̆-kăl) [⬙ ⫹ L. vesicula, little bladder] Around the urinary bladder.
perivesiculitis (pĕr⬙ı̆-vĕ-sı̆k⬙ū-lı̄⬘tı̆s) [⬙ ⫹
⬙ ⫹ Gr. itis, inflammation] Inflammation of tissues around a seminal vesicle.
perivisceritis (pĕr⬙ı̆-vı̆s⬙ĕr-ı̄⬘tı̆s) [⬙ ⫹ ⬙
⫹ ⬙] Inflammation of the tissues surrounding the visceral organs. SYN: perisplanchnitis.
perle (pĕrl) [Fr., pearl] A soft capsule
containing medicine.
perlèche (pĕr-lĕsh⬘) [Fr.] A disorder
marked by fissures and epithelial desquamation at the corners of the mouth,
esp. seen in children. The condition may
be due to oral candidiasis or may be a
symptom of dietary deficiency, esp. riboflavin deficiency.
perlingual
(pĕr-lı̆ng⬘gwăl)
[L. per,
through, ⫹ lingua, tongue] By way of
the tongue; a method of administering
medicines.
Perls’ stain [Max Perls, German pathologist 1843-1881] A histochemical stain
that demonstrates iron when it is
present in body tissues.
permanent (pĕr⬘mă-nĕnt) [⬙ ⫹ manere,
to remain] Enduring; without change.
permanganate (pĕr-măn⬘gă-nāt) Any
one of the salts of permanganic acid.
permeability (pĕr⬙mē-ă-bı̆l⬘ı̆-tē) [LL. permeabilis] The quality of being permeable; that which may be traversed.
capillary p. The condition of the capillary wall that enables substances in
the blood to pass into tissue spaces or
into cells, or vice versa.
permeable (pĕr⬘mē-ă-b’l) Capable of allowing the passage of fluids or substances in solution. SYN: pervious (1).
permeation (pĕr⬙mē-ā⬘shŭn) [L. permeare, permeate] Penetration of and
spreading throughout an organ, tissue,
or space.
permethrin (pĕr-mĕth-rı̆n) An insecticide and insect repellent that has been
used to treat scabies and lice infestations, and to protect people from tick exposure while working or playing outdoors.
permissible exposure limits (pĕr-mı̆s-săbl) The limits, usually expressed as a
combination of time and concentration,
to which humans may be safely exposed
to physical agents, ionizing radiation, or
chemical substances in the environment
in general and in work areas specifically. SEE: hazardous material; health
peroxide
hazard; maximum allowable concentration; right-to-know law.
permucosal (pĕr-mū-kō⬘săl, Across mucous membranes.
permutation (pĕr⬙mū-tā⬘shŭn) [L. per,
completely, ⫹ mutare, to change]
Transformation; complete change; act of
altering objects in a group.
pernicious (pĕr-nı̆sh⬘ŭs) [L. perniciosus,
destructive] Destructive; fatal; harmful.
p. trend In psychology, an abnormal
departure from conventional ideas and
social interests.
pernio (pĕr⬘nē-ō) [L.] Chilblain.
pero- [Gr. peros, maimed] Combining
form meaning deformed.
peroneal (pĕr⬙ō-nē⬘ăl) [Gr. perone, pin]
Concerning the fibula.
p. sign Eversion and dorsiflexion of
the foot resulting from tapping the peroneal nerve with a reflex hammer.
peroneo- [Gr. perone, pin] Combining
form meaning fibula.
peroneotibial (pĕr⬙ō-nē⬙ō-tı̆b⬘ē-ăl) [⬙ ⫹
L. tibia, shinbone] Concerning the fibula and tibia.
peroneus (pĕr⬙ō-nē⬘ŭs) [Gr. perone, pin]
One of three muscles of the leg that act
to move the foot.
p. brevis The muscle arising from the
distal two thirds of the lateral fibula and
attaching to the styloid process of the
base of the fifth metatarsal. The peroneus brevis assists in plantar flexion of
the foot and eversion of the ankle.
p. longus The muscle arising from
the lateral tibial condyle and the upper
two thirds of the fibula and inserting on
the lateral aspect of the first metatarsal
and the associated portion of the first
cuneiform. The peroneus longus is the
primary contributor to the plantar flexion of the foot and the eversion of the
ankle.
p. tertius The muscle arising from
the anterior portion of the distal one
third of the tibia and the adjacent portion of the interosseous membrane and
attaching on the dorsal surface of the
fifth metatarsal. The peroneus tertius is
a secondary contributor to ankle dorsiflexion and eversion. This muscle is absent in a significant proportion of the
population.
peroral (pĕr-or⬘ăl) [L. per, through, ⫹
oris, mouth] Administered through the
mouth.
per os (pĕr ōs) [L.] ABBR: po. By
mouth.
perosseous
(pĕr-ŏs⬘ē-ŭs)
[L. per,
through, ⫹ os, bone] Through bone.
peroxidase (pĕr-ŏk⬘sı̆-dās) [⬙ ⫹ Gr.
oxys, acid, ⫹ −ase, enzyme] An enzyme that catalyzes the decomposition
of hydrogen peroxide to water and oxygen; common in plant cells. This process
is essential to intracellular respiration.
peroxide (pĕr-ŏk⬘sı̄d) In chemistry, a
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peroxisome
1758
compound containing more oxygen than
the other oxides of the element in question.
peroxisome (pĕ-rŏks⬘ı̆-sōm) A class of
single-membrane-bound vesicles that
contain a variety of enzymes including
catalase. They are present in most human cells but are concentrated in the
liver. The absence of functional peroxisomes is involved in a number of diseases; the most severe is Zellweger’s
syndrome, which affects newborns and
is usually fatal before 1 year of age. This
syndrome consists of cirrhosis of the
liver and congenital malformations of
the central nervous system and skeleton.
per rectum (pĕr rĕk⬘tŭm) [L.] By the
rectum; through the rectum.
PERRLA (pŭr⬘lă) pupils equal, round, reactive to light and accommodation.
perseveration (pĕr-sĕv⬙ĕr-ā⬘shŭn) [L.
perseverare, to persist] 1. Abnormal,
compulsive, and inappropriate repetition of words or behaviors, a symptom
observed, for example, in patients with
schizophrenia or diseases of the frontal
lobes of the brain. 2. The repetition of
rhythmic but meaningless actions, behaviors, or movements.
Persian Gulf syndrome ABBR: PGS. A
term used to describe a variety of symptoms experienced by veterans of the
Persian Gulf war, including fatigue, loss
of memory, muscle and joint pains,
shortness of breath, and gastrointestinal complaints. The cause of these complaints is obscure.
persistent light reaction Photosensitivity.
persistent vegetative state A continuing
and unremitting clinical condition of
complete unawareness of the environment accompanied by sleep-wake cycles
with either complete or partial preservation of hypothalamic and brainstem
autonomic functions. The diagnosis is
established if the condition is present
for 1 month after acute or nontraumatic
brain injury or has lasted for 1 month in
patients with degenerative or metabolic
disorders or developmental malformations. SYN: vegetative state.
person (pĕr-sŭn) A human being.
persona (pĕr-sō⬘nă) [L., mask] 1. The
attitude or appearance a person presents to others. 2. Personality.
personal care attendant An employee
hired to assist a functionally limited
person with activities of daily living.
personal digital assistant ABBR: PDA.
A hand-held or pocket-sized computer
used to store information or communicate with others.
personal emergency alert system (pĕrsŭn-ăl) A device consisting of a portable
battery-powered help button and a machine that automatically dials a monitoring station. The device is connected
personality disorder
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to the individual’s telephone or to a
phone jack. When the system is activated, it either allows a two-way communication between the monitoring station and the individual or alerts the
station personnel to phone the individual. In the latter case, if there is no response the station may call a neighbor
or family member or dispatch emergency medical technicians to the person’s home.
personal equation A personal bias or peculiarity that may explain a difference
in approach or interpretation.
personalism (pĕr⬘sŭn-ă-lı̆zm) A social
theory of health care that stresses the
importance of respect for the dignity
and individuality of those people for
whom care is provided.
personality (pĕr-sŭn-ăl-ı̆tē) [LL. personalitas] The unique organization of
traits, characteristics, and modes of behavior of an individual, setting the individual apart from others and at the
same time determining how others react to the individual. SYN: persona (2).
SEE: personality test.
alternating p. Dissociative identity
disorder.
anal p. SEE: anal personality.
borderline p. SEE: borderline personality disorder.
compulsive p. Obsessive-compulsive
personality disorder.
extroverted p. SEE: extrovert.
inadequate p. A personality type in
which the individual is ineffective and
is physically and emotionally unable to
cope with the normal stress of living.
introverted p. SEE: introvert (1).
multiple p. Dissociative identity disorder.
obsessive-compulsive p. Obsessivecompulsive disorder.
paranoid p. Paranoid personality
disorder.
psychopathic p. Antisocial personality disorder.
type A p. SEE: under behavior.
type B p. SEE: under behavior.
personality disorder A pathological disturbance of the patterns of perception,
communication, and thinking that impairs a person’s ability to function effectively. Personality disorders are manifested in at least two of the following
areas: cognition, affect, interpersonal
functioning, or impulse control. Generally, the disorder is of long duration,
and its onset can be traced to early adolescence.
TREATMENT: Psychotherapy, psychopharmacological drugs, or a combination of the two is used in treating
these disorders although many personality disorders resist treatment.
antisocial p.d. A type of personality
disorder characterized by disregard for
the rights and feelings of others. It usu-
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personality disorder
1759
ally begins before age 15. In early childhood, lying, stealing, fighting, truancy,
and disregard of authority are common.
In adolescence, aggressive sexual behavior, excessive use of alcohol, and
drug use may be characteristic. In
adulthood, these behaviorial patterns
continue with the addition of poor work
performance, inability to function responsibly as a parent, and inability to
accept normal restrictions imposed by
the law. Affected people may repeatedly
perform illegal acts (e.g., destroying
property, harassing others, or stealing)
or pursue illegal occupations. They disregard the safety, wishes, rights, and
feelings of others. This type of personality disorder is not due to mental retardation, schizophrenia, or manic episodes. It is much more common in males
than females. This condition has been
referred to as psychopathy, sociopathy,
or dyssocial personality disorder.
avoidant p.d. A personality disorder
marked by a pervasive pattern of social
inhibition, feelings of inadequacy, and
hypersensitivity to criticism. This begins by early adulthood and is present
in various situations (e.g., school, work,
or activities involving contact with others). People with this disorder desire affection, security, certainty, and acceptance and may fantasize about idealized
relationships with others.
borderline p.d. A personality disorder in which there is difficulty in maintaining stable interpersonal relationships and self-image. This manifests as
unpredictable and impulsive behavior,
outbursts of anger, irritability, sadness,
and fear. Self-mutilation or suicidal behavior may be present. Sometimes
there is a chronic feeling of emptiness or
boredom. SEE: Nursing Diagnoses Appendix.
Cluster A p.d. A grouping of personality disorders sharing traits of odd behavior and social isolation. This group
of diagnoses includes paranoid, schizoid, and schizotypal personality disorders.
Cluster B p.d. A grouping of personality disorders sharing traits of attention seeking, highly excitable emotional
states, and unpredictable behavior.
This group includes antisocial, borderline, narcissistic, and histrionic personality disorders.
Cluster C p.d. A group of personality
disorders in which anxious and fearful
behavior is a prominent feature. This
group includes dependent, avoidant,
and obsessive-compulsive personality
disorders.
histrionic p.d. A personality disorder
marked by excessive emotionalism and
attention-seeking. Those affected are
active, dramatic, prone to exaggerate,
and subject to irrational, angry out-
personal protective equipment
bursts or tantrums. They express boredom with normal routines and crave
novelty and excitement. Behavior in interpersonal relationships is shallow,
vain, demanding, and dependent.
obsessive-compulsive p.d. Obsessive-compulsive disorder. SYN: obsessive-compulsive personality.
narcissistic p.d. A personality disorder marked by a grandiose sense of selfimportance and preoccupation with fantasies of unlimited success, power,
brilliance, or beauty. The individual believes that his problems are unique and
can only be understood by other “special” people. There is an exhibitionistic
need for admiration and attention, a
lack of empathy, and an inability to understand how others feel.
paranoid p.d. A personality disorder
characterized by unwarranted suspiciousness and mistrust of others, hypervigilance directed at hidden motives or
intent to harm, hypersensitivity to criticism, tendency to hold grudges and to
be easily offended, and reluctance to
confide in others. SYN: paranoid disorder.; SEE: paranoid disorder in Nursing
Diagnoses Appendix.
passive-aggressive p.d. A personality disorder marked by indirect resistance to demands for adequate occupational or social performance through
procrastination, dawdling, stubbornness, inefficiency, or forgetfulness. The
disorder begins in early childhood and
may manifest itself in refusal to complete routine tasks, complaints of being
misunderstood or unappreciated, sullen
or argumentative attitude, pronounced
envy of others, and behavior that alternates between hostile defiance and contrition.
schizoid p.d. A personality disorder
characterized by shyness, oversensitivity, seclusiveness, dissociation from
close interpersonal or competitive relationships, eccentricity, daydreaming,
preference for solitary activities, and inability to express anger or joy in situations that normally call for such a reaction. In most social interactions, those
affected seem cold or aloof.
personality test A neuropsychiatric assessment tool, such as the Minnesota
Multiphasic Personality Inventory– 2,
used to identify an individual’s predominant emotional makeup. Personality
tests measure adjustment, adventurousness, agitation, anxiety, coping
styles, depression, introversion, hypochondriasis, paranoia, and other emotional variables.
personalized medicine Theranostics.
personal protective equipment Clothing, masks, gloves, or other gear that
protects a person from exposure to noxious chemicals or transmissible diseases.
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personal representative
pertussis
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tient’s history that aids diagnosis because the patient denies that it is
present.
p. positive An element of a patient’s
history that aids diagnosis because the
patient affirms that it is present.
per tubam (pĕr tū⬘băm) [L.] Through a
tube.
perturbation (pĕr⬙tĕr-bā⬘shŭn) [L. perturbare, thoroughly disordered] 1. The
state of being greatly disturbed or agitated; uneasiness of mind. 2. A disturbance or a change in a structure or function, usually as a result of an external
influence.
pertussis (pĕr-tŭs⬘ı̆s) [L. per, through,
⫹ tussis, cough] An acute, contagious
disease characterized by paroxysmal
coughing, vomiting that follows the
cough, and whooping inspiration. The
disease is caused by a small, nonmotile,
gram-negative bacillus, Bordetella pertussis. The incubation period is 7 to 10
days. Treatment is symptomatic and
supportive. Antibiotics (e.g., erythromycin) are given to treat bacterial pneumonia and otitis media, esp. in infants
and young children, early in the course of
the infection. SYN: whooping cough (1).
PREVENTION: Pertussis may be prevented by immunization of infants beginning at 3 months of age. Booster vaccination (Tdap) should be given to
adolescents (at ages 11 to 18) and to susceptible adults.
SYMPTOMS: Pertussis is often divided into the following three stages:
Catarrhal: At this stage the symptoms are chiefly suggestive of the common cold— slight elevation of fever,
sneezing, rhinitis, dry cough, irritability, and loss of appetite.
Paroxysmal: This stage sets in after
approx. 2 weeks. The cough is more violent and consists of a series of several
short coughs, followed by a long drawn
inspiration during which the typical
whoop is heard, brought on by spasmodic contraction of the glottis. With
the conclusion of the paroxysm, vomiting is common. The number of paroxysms in 24 hr may vary from 3 or 4 to
40 or 50. The cough may be precipitated
by eating, drinking, or pressing on the
trachea.
Decline: This stage begins after an indefinite period of several weeks. Paroxysms grow less frequent and less violent, and after a period that may be
prolonged for several months, the cough
finally ceases.
PATIENT CARE: Parents are advised
that immunization prevents pertussis.
Vaccination should be given to children
and adolescents, except for those with a
history of known allergy. For those individuals who contract the disease, precautions are taken to prevent spread after the onset of symptoms. Bedrest,
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personal
representative
(pĕr⬘sı̆n-ı̆l
rĕp⬙rı̆-zĕn⬘-tă-tı̆v) Someone designated
to make health care decisions for another if that other person becomes incapable of making such decisions.
Person-Environment-Occupation-Performance model ABBR: PEOP. A conceptual model used by occupational therapists to guide clinical reasoning and
plan interventions. It emphasizes that
activity performance is influenced by
the capacity of the individual, the characteristics of the activity, and the resources and task demands of the environment.
persons in need of supervision ABBR:
PINS. A legal term for children who,
because of behavioral problems, require
supervision, usually in an institution.
person-years of life lost A calculation of
the impact of a disease on society owing
to premature death from the specific
disease; the number of years the person
would live if she or he had never contracted the disease.
perspiration (pĕr⬙spı̆r-ā⬘shŭn) [L. perspirare, breathe through] 1. The secretion of the sweat (sudoriferous) glands
of the skin; sweating. 2. The salty fluid
secreted through the sweat glands of
the skin; sweat. Essentially, the fluid is
a weak solution of sodium chloride, but
it also contains potassium, lactate, and
urea.
Perspiration is a means of removing
heat from the body. Evaporation of 1 L
of sweat removes 580 kcal of heat from
the body. Sweat loss varies from 100 to
1000 ml/hr but may exceed those
amounts in a hot climate.
Perspiration is increased by temperature and humidity of the atmosphere,
exercise, pain, nausea, nervousness,
mental excitement, dyspnea, diaphoretics, and shock. It is decreased by cold,
diarrhea, other causes of profound dehydration, and using certain drugs.
insensible p. Evaporation of water
vapor from the body without appearing
as moisture on the skin. SYN: insensible
sweating.
sensible p. Perspiration that forms
moisture on the skin.
perspire
(pĕr-spı̄r⬘)
[L. perspirare,
breathe through] To secrete fluid
through the pores of the skin. SYN:
sweat (3).
persuasion (pĕr-swā⬘zhŭn) The act of influencing the thinking or behavior of
others.
persulfate (pĕr-sŭl⬘fāt) One of a series of
sulfates containing more sulfuric acid
than the others in the same series.
Perthes’ disease (pĕr⬘tēz) [Georg C. Perthes, Ger. surgeon, 1869– 1927] Osteochondritis deformans juvenilis.
pertinent Relevant; clinically meaningful.
p. negative An element of the pa-
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pertussis immune globulin
1761
isolation, and a quiet environment are
provided. Because cough may be severe
and debilitating, remedies such as guaifenesin or benzonatate may be given.
Comfort measures are provided as indicated.
pertussis immune globulin A sterile solution of antibodies derived from the
blood of adults who have been immunized with pertussis vaccine; used to
produce passive immunity to pertussis.
pertussis vaccine SEE: under vaccine.
pertussoid
(pĕr-tŭs⬘oyd)
[L. per,
through, ⫹ tussis, cough, ⫹ Gr. eidos, form, shape] 1. Of the nature of
whooping cough. 2. A cough generally
similar to that of whooping cough.
per vaginam (pĕr vă-jı̄⬘năm) [L.]
Through the vagina.
pervasive (pĕr-vā⬘sı̆v) [L.pervadere, to
go through] Spreading widely and
deeply; affecting all aspects of something.
pervasive developmental disorder A
synonym for the autism spectrum of disorders, e.g., “classical” autism, Asperger
disorder, childhood disintegrative disorder (regressive autism), and Rett syndrome.
perversion (pĕr-vĕr⬘zhŭn) [L. perversus,
perverted] Deviation from the normal
path, whether it be in the area of one’s
intellect, emotions, actions, or reactions.
sexual p. A maladjustment of sexual
behavior in which satisfaction is sought
in ways that veer far from accepted cultural norms.
pervert (pĕr-vĕrt⬘) [L. pervetere, to turn
the wrong way] 1. To turn from the normal; to misuse. 2. One who has turned
from the normal or socially acceptable
path, esp. sexually.
pervious (pĕr⬘vē-ŭs) [L. pervius] 1. Permeable. 2. Penetrating.
pes (pĕs, pēz, pē⬘dēz) pl. pedes [L.] The
foot or a footlike structure.
p. abductus Talipes valgus.
p. adductus Talipes varus.
p. anserinus 1. The network of
branches of the facial nerve as it passes
through the parotid gland 2. The combined tendinous expansions of the sartorius, gracilis, and semitendinosus
muscles at the medial border of the tibial tuberosity.
p. cavus Talipes arcuatus.
p. contortus Talipes equinovarus.
p. equinovalgus A condition in
which the heel is elevated and turned
laterally.
p. equinovarus A condition in which
the heel is turned inward and the foot is
plantar flexed.
p. equinus A deformity marked by
walking without touching the heel to
the ground. SYN: talipes equinus.
p. gigas Macropodia.
pestle
p. hippocampi The lower portion of
the hippocampus major.
p. planus Flatfoot.
p. valgus Talipes valgus.
p. varus Talipes varus.
pesco- (pĕs⬘kō) [Sp.pescar, to fish] Combining form meaning fish.
pescovegetarian
(pĕs⬙kō-vĕj⬙ı̆-tār⬘ē-ı̆n)
[⬙ ⫹ ⬙] A person who eats a vegetarian
diet supplemented by fish.
pessary (pĕs⬘ă-rē) [L. pessarium] A device inserted into the vagina to function
as a supportive structure for the uterus.
A pessary may be inserted to treat
symptomatic uterine displacements. After manually repositioning the uterus,
the physician inserts the appropriatesize device; a woman should not feel a
well-fitted pessary. Pessaries should be
removed and cleaned frequently; however, this requires manual dexterity
and is difficult for elderly patients. Use
of an antibacterial cream or gel will help
decrease odor. Unless discomfort arises,
the device is removed about 6 weeks
later. If relief and anteversion occur, no
further treatment is necessary. If not,
the pessary is reinserted for another 6
weeks.
cup p. Pessary that has a cup-shaped
hollow that fits over the os uteri.
diaphragm p. A cup-shaped rubber
pessary used as a contraceptive device.
Hodge’s p. A pessary used to correct
retrodeviations of the uterus.
ring p. A round pessary.
pessimism (pĕs-ı̆-mı̆-zı̆m) A frame of
mind marked by loss of hope, confidence, or trust in a good outcome, even
when such an outcome is likely. SEE:
optimism.
therapeutic p. Nihilism (1).
pest (pĕst) [L. pestis, plague] 1. A noxious, destructive insect. 2. A fatal epidemic disease, esp. plague.
pesticemia (pĕs⬙tı̆-sē⬘mē-ă) [⬙ ⫹ Gr.
haima, blood] The presence of Yersinia
pestis in the blood.
pesticide (pĕs⬘tı̆-sı̄d) [⬙ ⫹ cida, killer]
Any chemical used to kill pests, esp. rodents and insects.
p. residue The amount of any pesticide remaining on or in food or beverages intended for human consumption.
restricted-use p. In the U.S., a pesticide known to have adverse effects on
the environment or on people; only individuals who have been specially
trained and certified as pesticide applicators may use it.
pestilence (pĕs⬘tı̆l-ĕns) [L. pestilentia]
An epidemic contagious disease. pestilential (pĕs-tı̆-lĕn⬘shăl), adj.
pestis (pĕs⬘tı̆s) [L.] Plague.
p. ambulans Ambulatory plague.
p. fulminans The most severe form of
plague.
pestle (pĕs⬘l) [L. pistillum] A device for
macerating drugs in a mortar.
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peyote
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substance is used as a base for ointments. It is not suitable for use as a
vaginal lubricant because it is not miscible in body secretions. SYN: soft paraffin.
liquid p. A mixture of liquid hydrocarbons obtained from petroleum. This
mixture is used as a vehicle for medicinal substances for local applications.
Light petrolatum is employed as a topical spray, whereas heavy petrolatum
was once used internally to treat constipation. SYN: mineral oil.
petroleum (pĕ-trō⬘lē-ŭm) [L. petra,
stone, ⫹ oleum, oil] An oily inflammable liquid found in the upper strata
of the earth; a hydrocarbon mixture.
petro-occipital (pĕt⬙rō-ŏk-sı̆p⬘ı̆-tăl) [⬙ ⫹
occipitalis, occipital] Concerning the
petrous portion of the temporal bone
and the occipital bone.
petrosa (pĕ-trō⬘să) [L. petrosus, stony]
The petrous part of the temporal bone.
petrosal (pĕt-rō⬘săl) [L. petrosus, stony]
Of, pert. to, or situated near the petrous
portion of the temporal bone.
petrositis (pĕt⬙rō-sı̄⬘tı̆s) [⬙ ⫹ Gr. itis, inflammation] Inflammation of the petrous region of the temporal bone.
petrosquamous (pĕt⬙rō-skwā⬘mŭs) [⬙ ⫹
squamosus, scaly] Pert. to the petrous
and squamous portions of the temporal
bone.
petrous (pĕt⬘rŭs) [L. petrosus] 1. Resembling stone. 2. Relating to the petrous portion of the temporal bone. SYN:
petrosal.
Peutz-Jeghers syndrome (pūtz-jā⬘kĕrs)
[Johannes
Laurentius Augustinus
Peutz, Dutch physician, 1886– 1957;
Harold J. Jeghers, U.S. physician,
1904– 1990] An inherited disorder
characterized by the presence of polyps
of the small intestine and melanin pigmentation of the lips, mucosa, fingers,
and toes. Anemia due to bleeding from
the intestinal polyps is a common finding.
pexin (pĕk⬘sı̆n) Rennet.
pexis (pĕk⬘sı̆s) [Gr., fixation] Fixation of
material to the tissue.
-pexy [Gr. pexis, fixation] A combining
form used as a suffix meaning fixation,
usually surgical.
Peyer’s patch (pı̄⬘ĕrz) [Johann Conrad
Peyer, Swiss anatomist, 1653– 1712] A
group of diffuse lymphoid nodules in the
mucosa of the small bowel. Part of the
mucosa-associated lymphoid tissue
(MALT), Peyer’s patches detect and respond to foreign antigens in the gastrointestinal tract. Antibodies secreted by
B cells in Peyer’s patches provide a significant defense against ingested pathogens. SYN: agminated follicle.
peyote (pā-ō⬘tē) [Nahuatl peyotl] 1. The
cactus plant, Lophophora williamsii,
from which the hallucinogen mescaline
is obtained. 2. The drug from the flow-
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PET
PET positron emission tomography.
peta- (pĕt) [Fm. penta, representing the
fifth power of a thousand] A prefix used
in the International System of Units (SI
units) to signify 1015.
petechiae (pē-tē⬘kē-ē) sing., petechia
[It. petecchia, skin spot] 1. Small, purplish, hemorrhagic spots on the skin
that appear in patients with platelet deficiencies (thrombocytopenias) and in
many febrile illnesses. SEE: illus.
2. Red spots from the bite of a flea.
PETECHIAE
petechial (pē-tē⬘kē-ăl) Marked by the
presence of petechiae.
Peter Pan syndrome (pē-tēr) The reluctance of an adult to adopt traditional
male adult behavior.
petiole (pĕt⬘ē-ōl) [LL. petiolus] A slender stalk or stem, as petiole of the epiglottic cartilage.
petition Complaint (2).
petit mal SEE: epilepsy.
Petri dish (pē⬘trē) [Julius Petri, Ger. bacteriologist, 1852– 1921] A shallow covered dish made of plastic or glass, used
to hold solid media for culturing bacteria.
petrifaction (pĕt-rı̆-făk⬘shŭn) [L. petra,
stone, ⫹ facere, to make] The process
of changing into stone or hard substance.
petrify (pĕt⬘rı̆-fı̄) To convert into stone;
make rigid.
pétrissage (pā⬙trē-săzh⬘) [Fr.] A massage technique that uses kneading or
squeezing of muscle groups across muscle fibers and is performed generally by
the tips of the thumbs, with the index
finger and thumb, or with the palm of
the hand. It is used principally on the
extremities. The operator picks up a
special muscle or tendon and, placing
one finger on each side of the part, proceeds in centripetal motion with a firm
pressure. SYN: kneading.
petro- [L. petra, stone] Combining form
meaning stone; pert. to the petrous portion of the temporal bone.
petrolatum (pĕt⬙rō-lā⬘tŭm) [L.] A purified semisolid mixture of hydrocarbons
obtained from petroleum. This occlusive
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Peyronie’s disease
1763
ering heads, buttons, of L. williamsii,
used by some Native Americans to produce altered states of consciousness. In
certain tribes the buttons are used in religious ceremonies.
Peyronie’s disease (pā-rō-nēz⬘) [François de la Peyronie, Fr. surgeon, 1678–
1747] A dorsal deformity or curvature
of the penis caused by fibrous tissue
within the tunica albuginea. When the
distortion of the penis is severe, the affected individual may experience erectile dysfunction or pain during sexual
intercourse.
TREATMENT: In many cases the contracture is mild, and those patients do
not require treatment. When pain is
present for more than 12 months, however, or when the deformity is severe or
interferes with erectile function, surgical repair of the defect may prove helpful.
Pfannenstiel incision (făn⬘ĕn-stēl) A
transverse curvilinear incision immediately above the pubic symphysis extending from the skin into the peritoneum.
The skin incision is continued transversely to include the anterior rectus
sheath, which is then reflected superiorly; the bellies of the rectus muscle are
separated longitudinally and the peritoneum is incised vertically. This surgical approach is used most often in gynecological procedures.
PFD personal flotation device. SEE: under
device.
Pfeiffer, Richard F. (fı̄⬘fĕr) German bacteriologist, 1858– 1945.
P.’s bacillus Haemophilus influenzae.
P.’s phenomenon A discovery made
in 1894 stating that the serum of guinea
pigs immunized with cholera vibrios destroyed cholera organisms in the peritoneal cavity of immune and nonimmune guinea pigs and that the same
reaction occurred in vitro. That same
lytic reaction occurred with typhoid and
Escherichia coli.
Pfiesteria piscicida (fēs-tĕr⬘ē-ă pı̆s-ı̆sı̄d⬘ā) [NL fish killer] A unicellular
marine organism, which may or may not
produce a toxin, depending on environmental conditions. When toxic, it has
been implicated in the death of millions
of fish in the estuaries of North Carolina, Delaware, and Maryland. The
toxin can become aerosolized, and if humans are exposed to it, severe neurological, mental, and physical illness may
occur. Specific therapy to combat the
toxin is not available, but concomitant
infections can be treated with tetracyclines.
P:F ratio The ratio of arterial partial pressure of oxygen to inspired fractional
concentration of oxygen; used to measure oxygen transfer.
PFT pulmonary function test.
phacoglaucoma
top of rh
base of rh
PG prostaglandin.
pg picogram.
PGA pteroylglutamic acid.
Ph 1. Pharmacopoeia. 2. Symbol
for
phenyl.
pH potential of hydrogen. A measure of
the hydrogen ion concentration of a solution. In chemistry, the degrees of acidity or alkalinity of a substance are expressed in pH values. A solution that is
neither acid nor alkaline is assigned a
pH of 7. Increasing acidity is expressed
as a number less than 7, and increasing
alkalinity as a number greater than 7.
Maximum acidity is pH 0 and maximum
alkalinity is pH 14. Because the pH
scale is logarithmic, there is a 10-fold
difference between each unit. For example, pH 5 is 10 times as acid as pH 6
and pH 4 is 100 times as acid as pH 6.
The pH of a solution may be determined
electrically by a pH meter or colorimetrically by the use of indicators. A list of
indicators and the pH range registered
by each is given under the indicator.
SEE: illus.; table; indicator.
PHA phytohemagglutinin.
phacitis (fă-sı̄⬘tı̆s) [Gr. phakos, lens, ⫹
itis, inflammation] Phakitis.
phaco- [Gr. phakos] Combining form denoting lens.
phacoanaphylaxis (făk⬙ō-ăn⬙ă-fı̄-lăk⬘sı̆s)
[Gr. phakos, lens, ⫹ ana, excessive, ⫹
phylaxis, protection] Hypersensitivity
to protein of the crystalline lens.
phacocele (făk⬘ō-sēl) [⬙ ⫹ kele, tumor,
swelling] Displacement of the lens from
its normal anatomic location. SYN: phacometachoresis.
phacocyst (făk⬘ō-sı̆st) [Gr. phakos, lens,
⫹ kystis, a sac] The capsule of the crystalline lens.
phacocystectomy (făk⬙ō-sı̆s-tĕk⬘tō-mē)
[⬙ ⫹ ⬙ ⫹ ektome, excision] Surgical
excision of part of the crystalline lens
capsule for treatment of cataract.
phacocystitis (făk⬙ō-sı̆s-tı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
itis, inflammation] Inflammation of the
capsule of the lens of the eye. SYN: phacohymenitis.
phacodenesis Wobbling of the lens during eye movement. It is caused by loss
of zonular attachments and is associated with pseudoexfoliation syndrome
and ocular trauma.
phacoemulsification
(făk⬙ō-ē-mŭl⬘sı̆-fı̆kā⬙shŭn) A method for removing the
lens of the eye in order to treat cataracts. An ultrasonic device is used to
fragment the lens, which is then removed via aspiration through a small
incision. SYN: phacofragmentation.
phacoerysis (făk⬙ō-ĕr-ē⬘sı̆s) [⬙ ⫹ eresis,
removal] Removal of the lens of the eye
by attaching a suction device, an erysiphake, to it. SEE: erysiphake.
phacofragmentation
(făk⬙ō-frăg⬙mĕntā⬘shŭn) Phacoemulsification.
phacoglaucoma (făk⬙ō-glaw-kō⬘mă) [⬙
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
1764
phacohymenitis
⫹ glaukos, green, ⫹ oma, tumor]
Lens changes induced by glaucoma.
SEE: glaucoma.
phacohymenitis (făk⬙ō-hı̄⬙mĕn-ı̄⬘tı̆s) [⬙
⫹ hymen, membrane, ⫹ itis, inflammation] Phacocystitis.
phacoid (făk⬘oyd) [⬙ ⫹ eidos, form,
shape] Lentil- or lens-shaped.
phacoiditis (făk⬙oy-dı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
itis, inflammation] Phakitis.
phacoidoscope (fă-koyd⬘ō-skōp) [⬙ ⫹ ⬙
⫹ skopein, to examine] Phacoscope.
phacolysis, phakolysis (făk-ŏl⬘ı̆-sı̆s) [⬙
⫹ lysis, dissolution] Any dissolution or
disintegration of the crystalline lens.
phacoma (fă-kō⬘mă) [⬙ ⫹ oma, tumor]
Phakoma.
phacomalacia (făk⬙ō-mă-lā⬘shē-ă) [⬙ ⫹
malakia, softening] A softening of the
lens, usually resulting from a soft cataract.
phacometachoresis
top of rh
base of rh
pH of Some Fluids
Material
pH
Decinormal HCl
Gastric juice
Thousandth-normal HCl
Pure water (neutral) at
25⬚C
Blood plasma
Pancreatic juice
Thousandth-normal
NaOH
Decinormal NaOH
1.0
1.0– 5.0
3.0
7.0
7.35– 7.45
8.4– 8.9
11.0
13.0
HCl—hydrochloric acid; NaOH—sodium hydroxide
phacomatosis (fā⬘kō-mă-tō-sı̆s) Phakomatosis.
phacometachoresis
(făk⬙ō-mĕt⬙ă-kō-rē⬘
INTESTINAL SECRETIONS
SALIVA
URINE
BLOOD
GASTRIC JUICE
GREATER ACIDITY
10ⴚ1
100
10ⴚ2
10ⴚ3
10ⴚ4
10ⴚ5
10ⴚ6
10ⴚ7
10ⴚ8
10ⴚ9
10ⴚ10 10ⴚ11
10ⴚ12 10ⴚ13 10ⴚ14
H⫹ ION CONCENTRATION
14
13
12
11
10
9
8
7
6
5
4
3
2
1
0
OH⫺ ION CONCENTRATION
10ⴚ14
10ⴚ13
10ⴚ12 10ⴚ11
10ⴚ10
10ⴚ9
10ⴚ8
10ⴚ7
10ⴚ6
10ⴚ5
10ⴚ4
10ⴚ3
10ⴚ2
10ⴚ1
100
GREATER ALKALINITY
PURE
WATER
RAIN
SEA
WATER
WATER
BAKING
SODA
COFFEE
LEMON
COLA
JUICE
ORANGE
JUICE
OVEN
CLEANER
DETERGENT
pH SCALE
Values of body fluids and some familiar solutions
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
phacometer
PARTICLE TO BE
INGESTED BY CELL
1765
CELL WALL BEGINS TO
PARTICLE ENCLOSED
SURROUND FOREIGN BODY IN PHAGOLYSOSOME
phagolysosome
top of rh
base of rh
ENZYMATIC DEGRADATION
OF PARTICLE BEGINS
PHAGOCYTOSIS
sı̆s) [⬙ ⫹ metachoresis, displacement]
Phacocele.
phacometer (făk-ŏm⬘ĕ-tĕr) [Gr. phakos,
lens, ⫹ metron, measure] A device for
ascertaining the refractive power of a
lens.
phacosclerosis (făk⬙ō-sklĕr-ō⬘sı̆s) [⬙ ⫹
sklerosis, a hardening] A hardening of
the crystalline lens of the eye.
phacoscope (făk⬘ō-skōp) [⬙ ⫹ skopein,
to examine] An instrument for observing change of curvature of the lens of the
eye during accommodation.
phacotoxic (făk⬙ō-tŏk⬘sı̆k) [⬙ ⫹ toxikon,
poison] The toxic effect of the lens of
the eye.
Phaedra complex (fā-dră) [Wife of King
Theseus of Athens] The love and attraction between a stepparent and a
stepchild; so named because of Phaedra’s tragic love for the son (Hippolytus)
of her husband by a previous marriage.
phaeohyphomycosis (fē⬙ō-hı̄⬙fō-mı̄-kō⬘sı̆s)
[Gr. phaeos, gray ⫹ Gr. hyphos, hyphe,
web, net ⫹ ⬙] Tissue infection with
fungi that have darkly pigmented hyphae.
SEE: hyalohyphomycosis.
phag- SEE: phago-.
phage (fāj) [Gr. phagein, to eat] Bacteriophage.
phagedena (făj-ĕ-dē⬘nă) [Gr. phagedaina] A sloughing ulcer that spreads
rapidly.
sloughing p. Hospital gangrene; bedsores.
phagedenic (făj-ĕ-dĕn⬘ı̆k) Concerning,
or of the nature of, phagedena.
phago-, phag- [Gr. phagein, to eat] Combining forms meaning eating, ingestion,
devouring.
phagocyte (făg⬘ō-sı̄t) [Gr. phagein, to
eat, ⫹ kytos, cell] White blood cells
(neutrophils and macrophages) that can
ingest and destroy microorganisms, cell
debris, and other particles in the blood
or tissues. SEE: endocytosis; macrophage; mononuclear phagocyte system;
neutrophil; phagocytosis; pinocytosis.
phagocytic (făg⬙ō-sı̆t⬘ı̆k) 1. Pert. to
phagocytes. 2. Pert. to phagocytosis.
phagocytize (făg⬘ō-sı̄t⬙ı̄z) To ingest bacteria and foreign particles by phagocytosis.
phagocytoblast (făg⬙ō-sı̄⬘tō-blăst) [⬙ ⫹
⬙ ⫹ blastos, germ] A cell that develops
into a phagocyte.
phagocytolysis (făg⬙ō-sı̄-tŏl⬘ı̆-sı̆s) [⬙ ⫹
kytos, cell, ⫹ lysis, dissolution] Destruction or disintegration of phagocytes. SYN: phagolysis.
phagocytolytic (făg⬙ō-sı̄⬙tō-lı̆t⬘ı̆k) Able to
destroy phagocytes.
phagocytose (făg⬙ō-sı̄⬘tōs) [⬙ ⫹ kytos,
cell] Phagocytize.
phagocytosis (făg⬙ō-sı̄-tō⬘sı̆s) [⬙ ⫹ ⬙ ⫹
osis, condition] A three-stage process
by which phagocytes (neutrophils,
monocytes, and macrophages) engulf
and destroy microorganisms, other foreign antigens, and cell debris. Generally, these substances must be covered
with opsonins, such as antibodies or
complement, to initiate binding with
cell receptors on the phagocytes, the
first stage in phagocytosis. In the second
stage, the particle is engulfed and enclosed in a vacuole (phagosome). During
the third stage, the phagosome merges
with lysosomes whose enzymes destroy
the engulfed particle. SEE: illus.; defensin; lysozyme; macrophage; neutrophil;
oxygen radical.
Most bacteria are killed during
phagocytosis by oxygen radicals, which
are formed during the respiratory burst
when phagosomes and lysosomes
merge. When oxygen radical production
is excessive, tissue damage occurs. Lysozymes, defensins, and bacteriocidal
permeability-increasing (BPI) protein
also destroy bacteria and other organisms; their actions do not depend on the
generation of oxygen radicals.
induced p. Phagocytosis that is stimulated by the presence of opsonins such
as antibodies.
spontaneous p. Phagocytosis that
occurs in the absence of opsonins.
phagodynamometer
(făg⬙ō-dı̄⬙nămŏm⬘ĕ-tĕr) [⬙ ⫹ dynamis, power, ⫹
metron, measure] A device that measures energy expended in chewing food.
phagolysis (făg-ŏl⬘ı̆-sı̆s) [⬙ ⫹ lysis, dissolution] Phagocytolysis.
phagolysosome (făg⬙ō-lı̄⬘sō-sōm) [⬙ ⫹
lysis, dissolution, ⫹ soma, body] The
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
phagosome
phanero-
top of rh
base of rh
distal p. The phalanx most remote from
the metacarpus or metatarsus. SYN: terminal phalanx; ungual phalanx.
metacarpal p. Any phalanx that articulates with a metacarpal bone. SEE:
proximal p.
metatarsal p. Any phalanx that articulates with a metatarsal bone. SEE:
proximal p.
middle p. When there are three phalanges, the phalanx intermediate between distal and proximal phalanges.
proximal p. Any phalanx that articulates with a metacarpal or metatarsal
bone.
terminal p. Distal p.
ungual p. Distal p.
Phalen’s test (fā⬘lĕnz) A maneuver used
in the physical diagnosis of carpal tunnel symptoms. The patient is asked to
flex the wrists while keeping the fingers
extended, typically by placing the dorsa
of the wrists together. The test is positive (suggestive of carpal tunnel syndrome) when wrist flexion produces
numbness in the distribution of the median nerve. The accuracy of the test is
limited. Also known as Phalen’s sign.
phall- [Gr. phallos, penis] Combining
form indicating penis.
phallalgia (făl-ăl⬘jē-ă) [Gr. phallos, penis, ⫹ algos, pain] Pain in the penis.
phallectomy (făl-ĕk⬘tō-mē) [⬙ ⫹ ektome, excision] Surgical removal of the
penis.
phallic (făl⬘ı̆k) Concerning the penis.
phalliform (făl⬘ı̆-form) [⬙ ⫹ L. forma,
form] Shaped like a penis.
phallitis (făl-ı̄⬘tı̆s) [⬙ ⫹ itis, inflammation] Inflammation of the penis.
phallocampsis (făl-ō-kămp⬘sı̆s) [⬙ ⫹
kampsis, a bending] Painful downward
curvature of the penis when erect.
phallocrypsis (făl⬙ō-krı̆p⬘sı̆s) [⬙ ⫹ krypsis, hiding] Contraction of the penis so
that it is almost invisible.
phallodynia (făl-ō-dı̆n⬘ē-ă) [⬙ ⫹ odyne,
pain] Pain in the penis.
phalloid (făl⬘oyd) [⬙ ⫹ eidos, form,
shape] Similar to a penis.
phalloidin (fă-loyd⬘ı̆n) A poisonous peptide from the mushroom Amanita phalloides. Ingestion of this can cause death
from fulminant hepatic failure.
phalloncus (făl-ŏn⬘kŭs) [⬙ ⫹ onkos,
mass] A tumor or swelling on the penis.
phalloplasty (făl⬘ō-plăs⬙tē) [⬙ ⫹ plassein, to form] Reparative or plastic surgery on the penis.
phallorrhagia (făl-ō-rā⬘jē-ă) [⬙ ⫹ rhegnynai, to burst forth] Hemorrhage from
the penis.
phallus (făl⬘ŭs) [Gr. phallos, penis]
1. The penis. 2. An artificial penis, used
as a symbol. 3. Embryonic structure developing at the tip of the genital tubercle that in the male develops into the
penis and in the female, the clitoris.
phanero-, phaner- [Gr. phaneros, visible]
short
standard
1766
vacuole formed when the membranebound phagosome inside a macrophage
fuses with a lysosome. SEE: phagosome.
phagosome (făg⬘ō-sōm) [⬙ ⫹ soma,
body] A membrane-bound vacuole inside a phagocyte that contains material
waiting to be digested. Digestion is facilitated by the fusion of the vacuole
with the lysosome. The phagosome is
then called a phagolysosome or a secondary lysosome. SEE: phagocytosis.
phagotype (făg⬘ō-tı̄p) [⬙ ⫹ typos, mark]
The classification of bacteria by their
sensitivity to phage types.
phakitis (făk-ı̄⬘tı̆s) [Gr. phakos, lens, ⫹
itis, inflammation] Inflammation of the
crystalline lens of the eye. SYN: phacitis; lentitis.
phakoma (fă-kō⬘mă) [⬙ ⫹ oma, tumor]
1. A tumor of glial tissue. 2. An area of
myelinated nerve fibers rarely seen in
the retina in association with neurofibromatosis. SYN: phacoma.
phakomatosis (fă⬙kō-mă-tō⬘sı̆s) [Gr.
phakos, lens, ⫹ oma, tumor, ⫹ osis,
condition] Any genetic neurocutaneous
disorders, in which anomalies are
spread unevenly through the body.
SYN: phacomatosis. SEE: Hippel’s disease; neurofibromatosis; sclerosis, tuberous; Sturge-Weber syndrome.
phalang- SEE: phalango-.
phalangeal (fă-lăn⬘jē-ăl) [Gr. phalanx,
closely knit row] Concerning a phalanx.
phalangeal depth ratio The thickness of
the finger at the base of the nail divided
by its thickness at the distal interphalangeal joint. A ratio greater than 1 is
indicative of clubbing.
phalangectomy (făl-ăn-jĕk⬘tō-mē) [⬙ ⫹
ektome, excision] Excision of one or
more phalanges.
phalanges (fă-lăn⬘jēz) Pl. of phalanx.
“Phalanges” is used as the plural of only
the anatomical sense of “phalanx;” “phalanxes” is the plural for all other senses
of “phalanx.”
phalangette (făl⬙ăn-jĕt⬘) The distal phalanx of a digit.
drop p. Falling of the distal phalanx
of a digit with loss of power to extend it
when the hand is pronated. This is due
to trauma or overstretching of the extensor tendon.
phalangitis (făl⬙ăn-jı̄⬘tı̆s) [Gr. phalanx,
closely knit row, ⫹ itis, inflammation]
Inflammation of one or more phalanges.
phalango-, phalang[Gr. phalanx,
closely knit row] Combining form
meaning phalanges (bones of fingers
and toes).
phalanx (fāl⬘ănks) pl. phalanges [Gr.,
closely knit row] 1. Any one of the
bones of the fingers or toes. SEE: skeleton. 2. One of a set of plates formed of
phalangeal cells (inner and outer) forming the reticular membrane of the organ
of Corti.
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
phanerogenic
1767
Combining forms meaning evident, visible.
phanerogenic (făn⬙ĕr-ō-jĕn⬘ı̆k) [⬙ ⫹
gennan, to produce] Indicating a disease with a known cause.
phanerosis (făn⬙ĕr-ō⬘sı̆s) [Gr.] The process of becoming visible.
phantasm (făn⬘tăzm) [Gr. phantasma]
An optical illusion; an apparition, or illusion of something that does not exist.
phantasmagoria
(făn-tăz-mă-gŏr⬘ē-ă)
[Gr. phantasma, an appearance, ⫹
agora, assembly, gathering] A series of
phantasms, deceptive illusions, either
imagined or remembered from a dream.
phantasmology (făn⬙tăz-mŏl⬘ō-jē) [⬙ ⫹
logos, word, reason] The study of
dreams, phantoms, and spiritually derived apparitions.
phantasy (făn⬘tă-sē) [Gr. phantasia,
imagination] Fantasy.
phantogeusia (făn-tō-gū⬘sē-ă) [⬙ ⫹
geusis, taste] An intermittent or persistent taste sensation not produced by
an external stimulus.
phantom (făn⬘tŭm) [Gr. phantasma, an
appearance] 1. An apparition. 2. A
model of the body or of one of its parts.
phantosmia (făn-tŏs⬘mē-ă) [⬙ ⫹ osme,
smell] An intermittent or persistent
perception of odor when no odor is inhaled.
Pharma The colloquial name for the
pharmaceutical industry. The largest
companies in the industry, in terms of
market capitalization, are sometimes
referred to as “Big Pharma.”
pharmacal (făr⬘mă-kăl) [Gr. pharmakon, drug] Concerning pharmacy.
pharmaceutical (făr-mă-sū⬘tı̆-kăl) [Gr.
pharmakeutikos] Concerning drugs or
pharmacy.
pharmaceutics (făr-mă-sū⬘tı̆ks) Pharmacy (1).
pharmacist (făr⬘mă-sı̆st) [Gr. pharmakon, drug] A druggist; one licensed to
prepare and dispense drugs. SYN:
apothecary.
pharmaco- [Gr. pharmakon, drug] Combining form meaning drug, medicine.
pharmacochemistry (făr⬙mă-kō-kĕm⬘ı̆strē) [⬙ ⫹ chemeia, chemistry] Pharmaceutical chemistry.
pharmacodiagnosis (făr⬙mă-kō-dı̄⬙ăg-nō⬘
sı̆s) [⬙ ⫹ dia, through, ⫹ gnosis,
knowledge] The use of drugs in making
a diagnosis.
pharmacodynamics
(făr⬙mă-kō-dı̄năm⬘ı̆ks) [⬙ ⫹ dynamis, power] The
study of drugs and their actions on living organisms.
pharmacoendocrinology (făr⬙mă-kō-ĕn⬙
dō-krı̆-nŏl⬘ō-jē) [⬙ ⫹ endon, within, ⫹
krinein, to secrete, ⫹ logos, word, reason] The pharmacology of the function
of endocrine glands.
pharmacoepidemiology (făr⬘mă-kō-ĕ-pı̆dĕm-ē-ŏl⬙ō-jē) The application of the
science of epidemiology to the study of
pharmacoresistant
the effects of drugs, desired and undesired, and uses of drugs in human populations.
pharmacogenetics (făr⬙mă-kō-jĕn-ĕt⬘ı̆ks)
[⬙ ⫹ genesis, generation, birth] The
study of the influence of hereditary factors on the response of individual organisms to drugs.
pharmacogenomics
(făr⬙mă-kō-jĕnŏm⬘ı̆ks, −nōm⬘) The study of the effects
of genetic differences among people and
the impact that these differences have
on the uptake, effectiveness, toxicity,
and metabolism of drugs.
pharmacogeriatrics
(făr-mă-kō-jĕr-ēă⬘trı̆ks) The study of the dynamics of
medication use in the elderly.
pharmacognosy (făr-mă-kŏg⬘nō-zē) [Gr.
pharmakon, drug, ⫹ gnōsis, knowledge] The scientific study of drugs originating in nature, i.e., derived from animals, minerals, and plants. The field
includes the characterization and cultivation, production, and standardization
of such drugs.
pharmacokinetics (făr⬙mă-kō-kı̄-nĕt⬘ı̆ks)
The study of the metabolism and action
of drugs with particular emphasis on
the time required for absorption, duration of action, distribution in the body,
and method of excretion.
pharmacologist (făr⬙mă-kŏl⬘ō-jı̆st) An
individual who by training and experience is a specialist in pharmacology.
pharmacology (făr⬙mă-kŏl⬘ō-jē) [⬙ ⫹
logos, word, reason] The study of drugs
and their origin, nature, properties, and
effects upon living organisms.
pharmacomania (făr⬙mă-kō-mā⬘nē-ă) [⬙
⫹ mania, madness] An abnormal desire to give or take medicines.
pharmacopeia (făr⬙mă-kō-pē⬘ă) [Gr.
pharmakopoeia, preparation of drugs]
An authorized treatise on drugs and
their preparation, esp. a book containing formulas and information that provide a standard for preparation and dispensation of drugs.
Pharmacopeia, United States (făr-măkō-pē⬘ă) ABBR: USP. A pharmacopeia
issued every 5 years, but with periodic
supplements, prepared under the supervision of a national committee of
pharmacists, pharmacologists, physicians, chemists, biologists, and other
scientific and allied personnel. The U.S.
Pharmacopeia was adopted as standard
in 1906. Beginning with the U.S. Pharmacopeia XIX, 1975, the National Formulary has been included in that publication.
pharmacophore (făr⬘mă-kō-for) [⬙ ⫹
phoros, bearing] The three-dimensional shape of a molecule that makes it
fit and activate cellular receptors.
pharmacoresistant
(făr⬙mă-kō-rēzı̆s⬘tănt) Unresponsive to drug therapy. The term is used to describe refractory infections or tumors.
top of rh
base of rh
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
pharmacotherapy
1768
pharmacotherapy (făr⬙mă-kō-thĕr⬘ă-pē)
[⬙ ⫹ therapeia, treatment] The use of
medicine in treatment of disease.
pharmacovigilance (făr⬙mă-kō-vı̆j⬘ı̆-lı̆ns)
[⬙ ⫹ ⬙] The analysis, detection, and
prevention of adverse effects caused by
medications.
pharmacy (făr⬘mă-sē) [Gr. pharmakon,
drug] 1. The practice of compounding
and dispensing medicinal preparations.
2. A drugstore.
pharmacy technician A technician who
assists the pharmacist in certain activities such as medication profile reviews
for drug incompatibilities, typing of prescription labels, prescription packaging,
handling of purchase records, and inventory control, and may, where state
law and hospital policy permit, dispense
drugs to patients under the supervision
of a registered pharmacist.
Pharm D Doctor of Pharmacy.
pharyng- SEE: pharyngo-.
pharyngalgia (făr⬙ı̆n-găl⬘jē-ă) [Gr. pharynx, throat, ⫹ algos, pain] Pain in the
pharynx.
pharyngeal (făr-ı̆n⬘jē-ăl) [L. pharyngeus]
Concerning the pharynx.
pharyngectomy (făr-ı̆n-jĕk⬘tō-mē) [Gr.
pharynx, throat, ⫹ ektome, excision]
Partial excision of the pharynx to remove growths or abscesses.
pharyngismus (făr⬙ı̆n-jı̆z⬘mŭs) [⬙ ⫹ −ismos, condition] Spasm of the muscles
in the pharynx. SYN: pharyngospasm.
pharyngitis (făr⬙ı̆n-jı̄⬘tı̆s) [⬙ ⫹ itis, inflammation] Inflammation of the mucous membranes and lymphoid tissues
of the pharynx, usually as a result of infection.
ETIOLOGY: The disease typically is
caused by viral or bacterial infections,
including influenza virus, Streptococcus
pyogenes, or Mycoplasma pneumoniae.
Occasionally, diphtheria or Candida albicans is responsible.
SYMPTOMS: The predominant symptom is throat pain. Fever, malaise, muscle aches, and painful swallowing also
are present.
TREATMENT: Gargling with warm
salty water provides topical relief. Analgesic drugs, fluids, throat lozenges, or
topical anesthetics also are helpful. If
rapid tests or culture results identify
streptococci, then penicillin or erythromycin usually is curative.
acute p. Inflammation of the pharynx with pain in the throat.
SYMPTOMS: Symptoms include malaise, fever, dysphagia, throat pain, and
difficulty swallowing.
TREATMENT: Local treatment includes gargles, lozenges, and topical application to the oral pharynx. General
treatment involves bedrest, adequate
fluids, and analgesics. An appropriate
antibiotic should be given if there is evidence of bacterial infection.
pharyngography
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atrophic p. A chronic form of pharyngitis with some atrophy of mucous
glands and abnormal secretion.
bacterial p. Severe, epidemic, pseudomembranous inflammation of the
fauces and tonsils caused by group A
beta-hemolytic streptococcus. It was formerly known as septic sore throat.
chronic p. Pharyngitis associated
with pathology in the nose and sinuses,
mouth breathing, excessive smoking,
and chronic tonsillitis. Dryness and irritation of the throat and a cough characterize this condition. Intranasal medication and removal of pathological
factors in sinuses and tonsillectomy are
the treatment choices.
diphtheritic p. Sore throat with general symptoms of diphtheria and formation of a true membrane.
granular p. Chronic pharyngitis with
granulations seen on the pharynx.
p. herpetica Pharyngitis characterized by formation of vesicles and ulcers.
hypertrophic p. Chronic pharyngitis
with thickened red mucous membrane
on each side with a glazed central portion.
membranous p. Pharyngitis characteristic of diphtheria, in which an exudate in the pharynx or on the tonsils
forms a false membrane.
streptococcal p. A common bacterial
infection of the throat and tonsils, esp.
in children between the ages of 5 and 15,
typically characterized by fever, sore
throat, painful swallowing, exudates on
the tonsils, and swollen anterior cervical lymph nodes. The disease is caused
by infection with group A beta-hemolytic streptococci and may be treated
with a variety of antibiotics, including
penicillins and macrolides. It may occasionally produce late complications,
including rheumatic fever or poststreptococcal glomerulonephritis.
p. ulcerosa Pharyngitis with fever,
pain, and the formation of ulcerations.
pharyngo-, pharyng- [Gr. pharynx,
throat] Combining forms meaning
throat.
pharyngocele (făr-ı̆n⬘gō-sēl) [⬙ ⫹ kele,
tumor, swelling] Hernia through the
pharyngeal wall.
pharyngoconjunctival fever, acute (fărı̆ng⬙gō-kŏn-jŭnk⬙tı̄⬘văl) ABBR: APC.
An acute disease consisting of fever,
pharyngitis, and conjunctivitis. Treatment is symptomatic.
pharyngoepiglottic, pharyngoepiglottidean (fă-rı̆ng⬙gō-ĕp⬙ı̆-glŏt⬘ı̆k, −glŏ-tı̆d⬘ē-
ăn) [⬙ ⫹ epi, upon, ⫹ glottis, glottis]
Concerning the pharynx and glottis.
pharyngoesophageal (fă-rı̆ng⬙gō-ē-sŏf⬘ăjē⬙ăl) [⬙ ⫹ oisophagos, esophagus]
Concerning the pharynx and esophagus.
pharyngography (făr-ı̆ng-gŏg⬘ră-fē) Radiographical examination of the phar-
short
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1769
ynx after ingestion of a contrast medium.
pharyngolaryngeal (fă-rı̆ng⬙gō-lă-rı̆n⬘jēăl) [⬙ ⫹ larynx, larynx] Concerning
the pharynx and larynx.
pharyngolith
(făr-ı̆n⬘gō-lı̆th)
[⬙
⫹
lithos, stone] A stone in pharyngeal
walls.
pharyngology (făr⬙ı̆n-gŏl⬘ō-jē) [⬙ ⫹ logos, word, reason] The branch of medicine dealing with the pharynx.
pharyngomaxillary
(fă-rı̆ng⬙gō-măk⬘sı̆lĕr⬙ē) [⬙ ⫹ L. maxilla, jawbone] Concerning the pharynx and maxillae.
pharyngomycosis
(făr-ı̆n⬙gō-mı̄-kō⬘sı̆s)
[⬙ ⫹ mykes, fungus, ⫹ osis, condition]
Disease of the pharynx caused by fungi.
pharyngonasal (fă-rı̆ng⬙gō-nā⬘săl) [⬙ ⫹
L. nasus, nose] Concerning the pharynx and nose.
pharyngo-oral (fă-rı̆ng⬙gō-or⬘ăl) [⬙ ⫹ L.
os, mouth] Concerning the pharynx
and mouth.
pharyngopalatine (fă-rı̆ng⬙gō-păl⬘ă-tı̄n)
[⬙ ⫹ L. palatum, palate] Concerning
the pharynx and palate.
pharyngoparalysis (făr-ı̆n⬙gō-păr-ăl⬘ı̆-sı̆s)
[⬙ ⫹ paralysis, a loosening at the side]
Paralysis of the muscles of the pharynx.
pharyngopathy (făr⬙ı̆n-gŏp⬘ă-thē) [⬙ ⫹
pathos, disease, suffering] Any disorder of the pharynx.
pharyngoplasty (făr-ı̆n⬘gō-plăs⬙tē) [⬙ ⫹
plassein, to form] Reparative surgery of
the pharynx (e.g., to treat obstructive
sleep apnea).
pharyngorhinoscopy
(făr-ı̆n⬙gō-rı̄nŏs⬘kō-pē) [⬙ ⫹ ⬙ ⫹ skopein, to examine] Nasopharyngoscopy.
pharyngoscope (făr-ı̆n⬘gō-skōp) [⬙ ⫹
skopein, to examine] An instrument for
visual examination of the pharynx.
pharyngoscopy (făr⬙ı̆n-gŏs⬘kō-pē) Visual examination of the pharynx.
pharyngospasm (făr-ı̆n⬘gō-spăzm) [⬙ ⫹
spasmos, a convulsion] Pharyngismus.
pharyngostenosis (fă-rı̆ng⬙gō-stē-nō⬘sı̆s)
[⬙ ⫹ stenosis, narrowing] Narrowing
or stricture of the pharynx.
pharyngotome (făr-ı̆n⬘gō-tōm) [⬙ ⫹
tome, incision] An instrument for incision of the pharynx.
pharyngotomy (făr-ı̆n-gŏt⬘ō-mē) Incision of the pharynx.
pharyngotonsillitis
(fă-rı̆ng⬙gō-tŏn⬙sı̆lı̄⬘tı̆s) [⬙ ⫹ L. tonsilla, almond, ⫹ Gr.
itis, inflammation] Inflammation of the
pharynx and tonsils.
pharynx (făr⬘ı̆nks) pl. pharynges [Gr.]
The passageway for air from the nasal
cavity to the larynx and for food from
the mouth to the esophagus. The pharynx participates in speech as a resonating cavity. SEE: pharyngitis; mouth for
illus.
ANATOMY: The pharynx is a musculomembranous tube extending from the
base of skull to the level of the sixth cervical vertebra, where it becomes contin-
phencyclidine hydrochloride
uous with the esophagus. The upper
portion, the nasopharynx, is above the
soft palate, lined with pseudostratified
ciliated epithelium, and has openings to
the posterior nares and eustachian
tubes. The middle part, the oropharynx,
is lined with stratified squamous epithelium and has an opening to the oral
cavity. The lowest part, the laryngopharynx, is also lined with stratified
squamous epithelium and opens inferiorly to the larynx anteriorly and the
esophagus posteriorly.
The nerve supply is from the autonomic nervous system and from the vagus and glossopharyngeal nerves. Blood
vessels branch from the external carotid
artery. Veins form an extensive pharyngeal plexus and drain into the internal
jugular vein.
phase (fāz) [Gr. phasis, an appearance]
1. A stage of development. 2. A transitory appearance. 3. In chemistry, a distinct component of a larger, heterogeneous system, as oil or water when the
two are mixed.
aqueous p. The water portion of a
mixture of liquids and solids.
continuous p. The state of a substance in a heterogeneous system in
which particles are continuous (e.g., the
water particles in which oil has been
dispersed).
disperse p. The state of a substance
in a heterogeneous system in which particles are separated from each other
(e.g., oil particles in water).
lag p. Lag (2).
phasic (fā⬘sı̆k) Of, or pert. to, a phase.
PhD Doctor of Philosophy.
phe phenylalanine.
phenanthrene (fē-năn⬘thrēn) C14H10, a
coal tar derivative that is carcinogenic.
phenate (fē⬘nāt) A salt of phenic acid
(phenol).
phencyclidine hydrochloride (fĕn-sı̆k⬘lı̆dı̆n⬙, −sı̄⬘klı̆, −dı̆n) ABBR: PCP. An anesthetic used in veterinary medicine. It
is also used illegally as a hallucinogen,
and referred to in slang as “PCP” or “angel dust.” The drug is potent; intoxication can occur from passive smoking,
and even small doses can produce excitement, hallucinations, and psychotic
or extremely violent behavior. Moderate
doses also cause elevated blood pressure, rapid pulse, increased skeletal
muscle tone, and sometimes, myoclonic
jerking. Large doses can cause seizures,
ataxia, nystagmus, respiratory depression, and death. The pupils of patients
intoxicated with PCP are usually of normal size or small but not the pinpoint
size seen in opiate use. This, together
with the other physical findings, may
help clinicians diagnose overdosed patients.
TREATMENT: For agitation caused
by acute intoxication, diazepam is indi-
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phenobarbital
phenylketonuria
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perazine, and thioridazine. Side effects
of these drugs include dystonic reactions, tardive dyskinesia, seizures, and
sedation. SEE: neuroleptic.
phenotype (fē⬘nō-tı̄p) [Gr. phainein, to
show, ⫹ typos, type] The expression
of the genes present in an individual.
This may be directly observable (e.g.,
eye color) or apparent only with specific
tests (e.g., blood type). Some phenotypes, such as the blood groups, are
completely determined by heredity,
while others are readily altered by environmental agents. SEE: genotype.
phenozygous (fē-nŏz⬘ı̆-gŭs) [⬙ ⫹ zygon,
yoke] Possessing a cranium much narrower than the face.
phentermine (fĕn⬘tĕr-mēn) An amphetamine-like substance that enhances
weight loss. When used with fenfluramine hydrochloride, a similar drug, it
has been implicated in the destruction
of the pulmonary valve of a small percentage of patients.
phenyl (fĕn⬘ı̆l, fē⬘nı̆l) The univalent radical of phenol, C6H5.
phenylalanine (fĕn⬙ı̆l-ăl⬘ă-nı̄n) ABBR:
phe. An essential amino acid, one of the
two linked amino acids in the sugar substitute aspartame. The genetically determined inability to dispose of excess
phenylalanine is known as phenylketonuria (PKU). SEE: phenylketonuria.
phenylamine (fĕn-ı̆l⬘ă-mēn) C6H7N; the
simplest aromatic amine, an oily liquid
derived from benzene. It is used in manufacture of dyes for medical and industrial purposes. SYN: aminobenzene.
phenylethylamine
(fĕn⬙ı̆l-ĕth⬙ı̆l-ăl⬘ămēn⬙) ABBR: PEA. An alkaloid synthesized from the amino acid phenylalanine. It is found in the brain, where it
contributes to the release of dopamine
and endorphins. It is concentrated in
chocolate and thought to be an antidepressant.
phenylhydrazine (fĕn⬙ı̆l-hı̄⬘dră-zēn) An
oily nitrogenous base used as a test for
the presence of sugar in the urine.
phenylketonuria
(fĕn⬙ı̆l-kē⬙tō-nū⬘rē-ă)
ABBR: PKU. A congenital autosomal
recessive disease marked by failure to
metabolize phenylalanine to tyrosine. It
results in severe neurological deficits in
infancy if it is unrecognized or left untreated. PKU is present in about 3.5 in
10,000 newborns in the U.S. In this disease, phenylalanine and its by-products
accumulate in the body, esp. in the nervous system, where they cause severe
mental retardation (IQ test results often below 40), seizure disorders, tremors, gait disturbances, coordination deficits, and psychotic or autistic behavior.
Eczema and an abnormal skin odor also
are characteristic. The consequences of
PKU can be prevented if it is recognized
in the first weeks of life and a phenylalanine-restricted (very low protein)
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1770
cated. Because PCP abusers are often
hostile, aggressive, and dangerous, efforts to pacify these patients are contraindicated. Instead, the patient should
be isolated in a quiet room and protective measures taken to avoid injury to
self or others.
PROGNOSIS: Despite medication and
psychotherapy, the psychotic symptoms
produced by PCP may persist for weeks
or months.
phenobarbital (fē⬙nō-băr⬘bı̆-tăl) Phenylbarbituric acid, a sedative, hypnotic,
and anticonvulsant drug.
phenocopy (fē⬘nō-kŏp⬙ē) [Gr. phainein,
to show, ⫹ copy] An individual with
a biochemical or physical characteristic
that resembles that produced by a genetic mutation but is instead due to an
environmental condition.
phenol (fē⬘nōl) 1. C6H5OH; a crystalline,
colorless or light pink solid, melting at
43⬚C, obtained from the distillation of
coal tar. It has a characteristic odor and
is dangerous because of its rapid corrosive action on tissues. SYN: carbolic
acid. 2. Any of the aromatic derivatives
of benzene with one or more hydroxyl
groups attached.
phenology (fē-nŏl⬘ō-jē) [Gr. phainesthai,
to appear, ⫹ logos, word, reason] The
study of the effects of climate on living
things.
phenolsulfonphthalein
(fē⬙nŏl-sŭl⬙fōnthăl⬘ē-ı̆n) ABBR: P.S.P. A bright red organic chemical C19H14O5S used diagnostically in studies of kidney function,
bladder emptying, and, after intra-amniotic injection, in invasive tests for premature rupture of membranes. SYN:
phenol red.
phenomenology (fĕ-nŏm⬙ĕ-nŏl⬘ō-jē) [Gr.
phainomenon, appearing, ⫹ logos,
word, reason] 1. The study and classification of phenomena. 2. The science of
the subjective processes by which phenomena are presented, with emphasis
on mental processes and essential elements of experiences. A phenomenological study emphasizes a person’s descriptions of and feelings about
experienced events.
phenomenon (fĕ-nŏm⬘ĕ-nŏn) pl. phenomena [Gr. phainomenon, appearing]
Any observable or objective symptom,
sign, event, or fact.
on-off p. In Parkinson’s patients, the
alternating periods of good control
(“on”) and poor control (“off”) of their
symptoms. The on-off phenomenon is often experienced in patients undergoing
L-dopa therapy.
phenothiazines
(fē⬙nō-thı̄⬘ă-zēnz)
A
class of major tranquilizers used to treat
psychotic illnesses such as schizophrenia. They have neuroleptic and antiemetic effects. Among the most commonly used agents in this class are
chlorpromazine, haloperidol, prochlor-
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1771
diet is maintained throughout infancy,
childhood, and young adulthood. SYN:
Folling’s disease.
PREVENTION: The U.S. Preventive
Services Task Force recommends that
all newborns be screened for PKU before discharge from the nursery or in the
first 2 weeks of life. The test’s accuracy
is highest if it is performed no sooner
than 24 hr after birth. Mass screening
for the disease began in the 1960s. Some
women with PKU are now of childbearing age. During their pregnancies, strict
adherence to a low-phenylalanine diet
will help to prevent fetal malformations. Chorionic villus sampling can detect PKU prenatally.
PATIENT CARE: Testing newborns
for PKU is typically performed with a
heel-stick specimen of blood, which is allowed to dry on blotting paper before being sent to the lab for the Guthrie test.
The presence of phenylpyruvic acid in
the urine also confirms the diagnosis (a
few drops of 10% ferric acid are added
to a wet diaper, resulting in a deep, bluish coloration if the test is positive.
Since urinary levels of the acid vary according to the amount of protein ingested, testing should be repeated 4 to
6 weeks after birth. If elevated levels of
phenylalanine are found, additional
tests are performed to confirm the diagnosis.
Effective treatment requires that
phenylalanine blood levels be maintained between 3 and 9 mg/dl. This
means severely limiting natural proteins in the diet, as most contain 5%
phenylalanine. An enzymatic hydrolysate of casein (Lofenalac or Pregestimil)
is substituted for milk for affected infants, providing normal amounts of protein other than phenylalanine, plus additional carbohydrates and fat. As the
child grows, breads, cheese, eggs, flour,
meat, poultry, fish, nuts, milk, legumes,
and phenylalanine-type sugar substitutes must be avoided. Frequent blood
and urinary testing evaluates dietary
effects. Overzealous restriction can
cause phenylalanine deficiency. Parents
also need to understand normal growth
and development to help them to recognize development delays related to
PKU. As the child becomes older and dietary supervision by parents less possible, restriction deviations are more
likely to occur, putting the child at risk
for neurological damage. Involving the
child from early on in choosing permitted low-protein foods that he/she prefers
helps to develop responsible behaviors.
phenylpyruvic acid (fĕn⬙ı̆l-pı̄-roo⬘vı̆k) A
metabolic derivative of phenylalanine.
phenylpyruvic acid oligophrenia A form
of inherited mental retardation resulting from phenylketonuria.
pheochromocytoma
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phenylthiocarbamide
(fĕn⬙ı̆l-thı̄⬙ō-kăr⬘bămı̄d) ABBR: PTC. A chemical used in
studying medical genetics to detect the
presence of a marker gene. About 70%
of the population inherit the ability to
note the taste of phenylthiocarbamide
to be extremely bitter. To the remainder
of the population, it is tasteless. The
gene for tasting is dominant and is expressed in both homozygous and heterozygous individuals. SYN: phenylthiourea.
phenylthiourea (fĕn⬙ı̆l-thı̄⬙ō-ū-rē⬘ă) Phenylthiocarbamide.
phenytoin (fĕn⬘ı̆-tō-ı̆n) An anticonvulsant drug used primarily to treat patients with seizure disorders, including
tonic-clonic and partial complex seizures and status epilepticus. It also can
be used as an antiarrhythmic drug. Side
effects of phenytoin include hyperplasia
of the gums, ataxia, nystagmus, and
neurological depression. Its use alters
the metabolism of many other drugs
that the liver degrades. SYN: diphenylhydantoin sodium.
Because of the drug’s effects on
heart rhythm, cardiac monitoring
is required during intravenous infusions.
pheochrome
(fē⬘ō-krōm) [Gr. phaios,
dusky, ⫹ chroma, color] Staining
darkly with chrome salts.
pheochromoblast (fē⬙ō-krō⬘mō-blăst) [⬙
⫹ ⬙ ⫹ blastos, germ] Embryonic cells
that develop into pheochromocytes.
pheochromocyte (fē⬙ō-krō⬘mō-sı̄t) [⬙ ⫹
⬙ ⫹ kytos, cell] A chromaffin cell, such
as one of those in the adrenal medulla,
that gives a positive chromaffin reaction, i.e., it yields a yellowish reaction
with chrome salts.
pheochromocytoma
(fē-ō-krō⬙mō-sı̄tō⬘mă) [⬙ ⫹ ⬙ ⫹ ⬙ ⫹ oma, tumor] A
tumor derived from neural crest cells of
the sympathetic nervous system that is
responsible for about 0.1% to 2% of all
cases of hypertension. The tumor releases catecholamines (e.g., norepinephrine and epinephrine), which cause episodic or sustained signs and symptoms
(e.g., palpitations, sweating, headaches,
fainting spells, tremor, nausea, dyspepsia, pallor, chest or abdominal pain,
hyperglycemia, weakness, anxiety or
feelings of impending doom, and hypertensive emergencies). It may result
from an inherited autosomal dominant
trait. All races and both sexes are affected, with symptoms most commonly
beginning between ages 30 and 40. SEE:
catecholamine; multiple endocrine neoplasia; paraganglioma; Nursing Diagnoses Appendix.
This neuroendocrine tumor is one of
the surgically correctable forms of hypertension. It may be difficult to diag-
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pheomelanins
1772
nose because the symptoms it causes
are found in other, more common, conditions (e.g., anxiety disorders, alcohol
withdrawal, and hyperthyroidism).
The tumor is located in the adrenal
gland itself in about 85% of cases, but
sympathetic tissues are distributed
widely throughout the body. As a result,
catecholamine-releasing tumors may be
found in the urinary bladder, carotid
bodies, paravertebral tissues, and other
sites in the neck, thorax, abdomen, or
pelvis. Neuroendocrine tumors found
outside the adrenal glands are called
paragangliomas. Some patients have
multiple tumors. About 10% of patients
with pheochromocytoma also have multiple endocrine neoplasias, one of several genetic syndromes in which pheochromocytomas are associated with
adenomas or tumors of other glands.
DIAGNOSIS: The patient’s urine or
blood is tested to determine whether it
contains excessive levels of catecholamines or their metabolites. If so, imaging studies (e.g., computed tomography, magnetic resonance imaging, or
radioisotope or nuclear scanning) are
used to locate the tumor before surgery.
PATIENT CARE: Anesthesia for this
surgery is challenging because of the hemodynamic instability that can occur
during and after the procedure. Hypotension is treated with dopamine, and
hypertensive episodes, occurring most
commonly during induction, intubation,
or tumor manipulation, are treated with
nitroprusside or alpha blockers. For the
first 24 hr postoperatively when vasopressors, plasma volume expanders,
and IV fluids may be required, ICU
monitoring is recommended. Other
postoperative care includes continuous
cardiac monitoring for arrhythmias, hemodynamic monitoring, and assessment for heart failure and angina. Postoperative hypertension is common due
to the stress of surgery and adrenal
gland manipulation that stimulates catecholamine secretion. Blood pressure
must be closely monitored, a quiet, cool
environment provided, and clothing and
bedding changed as needed in response
to the sweating that may occur. Careful
blood pressure assessment continues
through the first 2 postoperative days,
when blood pressure may fall. Postoperative orthostatic hypotension may be
a threat to patient safety. Until it resolves, patients need to be taught to get
up from the bed or chair slowly and hold
on to a solid object. To collect diagnostic
specimens from stress-free subjects, the
patient is often placed on bedrest. Drugs
are withheld that may block or augment
test results for catecholamines or metanephrines. If a tumor is identified and
surgery is planned, preoperative hydration of the patient prevents hypotension
-philia
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during anesthetic induction. Medications to blunt the effect of catecholamines (e.g., alpha-adrenergic blocking
agents and then beta-adrenergic blocking agents) are administered for 1 to 2
weeks before surgery. Postoperatively,
vital signs (esp. blood pressure, via an
arterial line), cardiac rhythms, fluid balance, and electrolytes are monitored
closely. Analgesics are provided to manage pain, and the blood pressure response is assessed closely so that dosing
can be titrated to prevent hypotensive
episodes. The abdomen is auscultated
for returning bowel sounds and observed for distention. The health care
team reassures the patient and family
throughout diagnosis and management
because the symptoms of this condition
often fluctuate dramatically. After discharge, long-term follow-up should be
provided by an endocrinologist experienced in the care of patients with pheochromocytoma.
pheomelanins (fē-ō-mĕl⬘ă-nı̆nz) [⬙ ⫹
Gr. melas, black] Yellow-brown, sulfurcontaining pigments present as the pigment in human red hair.
pheresis (făr-ē⬘sı̆s) The removal of blood
or other body fluids from a patient, separating certain elements (e.g., immunoglobulins, platelets, or red blood cells)
and reinfusing the remaining elements
into the patient. SEE: leukapheresis;
plateletpheresis; plasmapheresis.
pheromone (fĕr⬘ō-mōn) A chemical released by one animal that acts as a form
of communication with other animals of
the same species. It is often detected by
smell and may affect the development,
reproduction, or behavior of other individuals.
Ph.G. German Pharmacopeia; Graduate
in Pharmacy.
PHI Protected health information.
phial (fı̄⬘ăl) [Gr. phiale, a bowl] A small
vessel for medicine; a vial.
Philadelphia collar (fı̆l-ă-dĕl⬘fē-ă) A
lightweight orthosis for the head and
neck used to restrict cervical movement.
SEE: illus.
-philia, -phil, −philic (fı̆l⬘ē-ă) [Gr. philein,
PHILADELPHIA COLLAR
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philosophy
1773
to love] Combining forms used as a suffix meaning love for, tendency toward,
craving for.
philosophy (fı̆-lŏs⬘ō-fē) 1. The love or
pursuit of knowledge. 2. A culturally determined system of beliefs, concepts,
theories, or convictions.
philtrum (fı̆l-trŭm) The median groove
on the external surface of the upper lip.
phimosis (fı̄-mō⬘sı̆s) [Gr., a muzzling]
Stenosis or narrowness of the preputial
orifice so that the foreskin cannot be
pushed back over the glans penis. The
condition is treated by circumcision.
p. vaginalis Narrowness or closure of
the vaginal orifice.
PHI-motion angiography A laser imaging test to identify abnormal blood vessels in the choroidal layer beneath the
retina. These abnormal vessels may
leak, causing central visual field loss in
age-related macular degeneration.
phlebalgia (flĕ-băl⬘jē-ă) [Gr. phlebos,
vein, ⫹ algos, pain] Pain arising from
a vein.
phlebangioma (flĕb⬙ăn-jē-ō⬘mă) [⬙ ⫹
angeion, vessel, ⫹ oma, tumor] An
aneurysm occurring in a vein.
phlebarteriectasia
(flĕb⬙ăr-tē⬙rē-ĕktā⬘zē-ă) [⬙ ⫹ arteria, artery, ⫹ ektasis, dilatation] Dilatation of blood
vessels.
phlebectasia, phlebectasis
(flĕb-ĕktā⬘zē-ă, −ĕk⬘tă-sı̆s) [⬙ ⫹ ektasis, dilatation] Varicosity.
phlebectomy (flĕb-ĕk⬘tō-mē) [⬙ ⫹ ektome, excision] Surgical removal of a
vein or part of a vein.
phlebitis (flĕ-bı̄⬘tı̆s) [⬙ ⫹ itis, inflammation] Inflammation of a vein. SYN:
thrombophlebitis. SEE: Nursing Diagnoses Appendix. phlebitic, adj.
ETIOLOGY: Common causes include
chemical or mechanical irritation of
veins by sclerosing intravenous fluids or
indwelling catheters, thrombosis, or venous infections.
SYMPTOMS: When a superficial vein
is affected, the affected vein often is
painful, tender, red, warm to touch, indurated along its length, or swollen. Inflammation or occlusion of large or deep
veins may be asymptomatic or may produce edema distal to the lesion, as well
as chills and fever and pain.
PREVENTION: Immobilized patients
are at risk for phlebitic disorders. To
prevent phlebitis, concentrated or irritating infusions should be given
through central venous catheters or
ports. Irritated or reddened intravenous
sites should be changed, and peripheral
catheters should never be left in place
longer than 96 hr in adults, according to
CDC guidelines. Patients with a history
of deep venous thrombosis should adhere closely to anticoagulant drug regimens and avoid prolonged sitting or
bedrest. They should avoid medications
phlebography
that increase the risk of thrombosis,
such as estrogen-containing compounds.
PATIENT CARE: The Infusion Nurses
Society has established the following
clinical criteria to grade phlebitis:
0. no symptoms;
1. erythema at access site with or
without pain;
2. pain at access site with erythema
or edema;
3. pain at access site with erythema,
streak formation, or palpable venous
cord;
4. pain at access site with erythema,
streak formation, palpable venous cord
longer than 1 inch (2.5 cm), or purulent
drainage.
Superficial and deep vein phlebitis
are treated by elevating the extremity
along its length and applying warm continuous moist heat for 72 hr to reduce
inflammation and relieve pain. Analgesics and anti-inflammatory drugs also
are provided to manage discomfort. Any
offending solution or catheter is removed from the vein. Phlebitis caused
by clots may be treated with antiplatelet or anticoagulant drugs, thrombolytic
agents (streptokinase), or, in rare cases,
surgery. Antibiotics and/or surgery may
be required for venous infections. The
circumference of the affected extremity
should be measured daily at the same
location and compared to the unaffected
one. When anticoagulant therapy is
used, precautions are taken to monitor
its effects and limit the risk of bleeding.
adhesive p. Phlebitis in which the
vein tends to become obliterated.
chemical p. Inflammatory damage to
the lining of blood vessels, caused by infusions of highly acidic, highly basic, hypertonic, or sclerosing fluids.
migrating p. A transitory phlebitis
that appears in a portion of a vein and
then clears up, only to reappear later in
another location.
p. nodularis necrotisans Circumscribed inflammation of cutaneous veins
resulting in nodules that ulcerate.
obliterative p. Phlebitis in which the
lumen of a vein becomes permanently
closed.
puerperal p. Venous inflammation
following childbirth.
sclerosing p. Phlebitis in which the
veins become obstructed and hardened.
sinus p. Inflammation of a sinus of
the cerebrum.
suppurative p. Phlebitis characterized by the formation of pus.
phlebo- [Gr. phleps, phlebos] Combining
form meaning vein.
phlebogram (flĕb⬘ō-grăm) [Gr. phlebos,
vein, ⫹ gramma, something written]
An infrequently used term for venogram.
phlebography
(flĕ-bŏg⬘ră-fē)
[⬙
⫹
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phlebolith
1774
graphein, to write] An infrequently
used term for venography.
phlebolith, phlebolite (flĕb⬘ō-lı̆th, −lı̄t) [⬙
⫹ lithos, a stone] A stone within a
vein.
phlebolithiasis (flĕb⬙ō-lı̆-thı̄⬘ă-sı̆s) [⬙ ⫹
lithiasis, forming stones] The formation of phleboliths in veins.
phlebology (flĕb-ŏl⬘ō-jē) [⬙ ⫹ logos,
word, reason] The science of veins and
their diseases.
phlebomanometer (flĕb⬙ō-mă-nŏm⬘ĕ-tĕr)
[⬙ ⫹ manos, thin, ⫹ metron, measure] A device for the direct measurement of venous pressure.
phlebometritis (flĕb⬙ō-mĕ-trı̄⬘tı̆s) [⬙ ⫹
metra, uterus, ⫹ itis, inflammation]
Inflammation of uterine veins.
phlebomyomatosis
(flĕb⬙ō-mı̄⬙ō-mătō⬘sı̆s) [⬙ ⫹ mys, muscle, ⫹ oma, tumor, ⫹ osis, condition] Thickening of
the tissue of a vein from an overgrowth
of muscular fibers.
phlebopexy (flĕb⬘ō-pĕk⬙sē) [⬙ ⫹ peksis,
fixation] Extraserous transplantation
of the testes for varicocele, with preservation of the venous network.
phlebophlebostomy
(flĕb⬙ō-flĕ-bŏs⬘tōmē) [⬙ ⫹ phlebos, vein, ⫹ stoma,
mouth] Surgical anastomosis of veins.
phleboplasty (flĕb⬘ō-plăs⬙tē) [⬙ ⫹ plassein, to form] Plastic repair of an injured vein.
phleborrhagia (flĕb⬙ō-rā⬘jē-ă) [⬙ ⫹
rhegnynai, to burst forth] Bleeding
from a vein.
phleborrhaphy (flĕb-or⬘ă-fē) [⬙ ⫹ rhaphe, seam, ridge] Suturing of a vein.
phleborrhexis (flĕb⬙ō-rĕk⬘sı̆s) [⬙ ⫹
rhexis, rupture] Rupture of a vein.
phlebosclerosis (flĕb⬙ō-sklē-rō⬘sı̆s) [⬙ ⫹
sklerosis, hardening] Fibrous hardening of a vein’s walls.
phlebostenosis (flĕb⬙ō-stĕ-nō⬘sı̆s) [⬙ ⫹
stenosis, narrowing] Constriction of a
vein.
phlebothrombosis (flĕb⬙ō-thrŏm-bō⬘sı̆s)
[⬙ ⫹ thrombos, a clot] Clotting in a
vein; phlebitis with secondary thrombosis.
phlebotomist (flĕ-bŏt⬘ō-mı̆st) [⬙ ⫹
tome, incision] One who draws blood.
phlebotomize (flĕ-bŏt⬘ō-mı̄z) To take
blood from a person.
Phlebotomus (flĕ-bŏt⬘ō-mŭs) [⬙ ⫹
tome, incision] A genus of insects, the
sandflies, belonging to the family Psychodidae, order Diptera. These bloodsucking insects transmit various forms
of leishmaniasis, sandfly (pappataci) fever, and Oroya fever.
P. argentipes In India, the transmitter of Leishmania donovani, causative
agent of kala-azar.
P. chinensis Transmitter of kalaazar in China.
P. papatasii Transmitter of the causative agent of sandfly fever. The virus is
phlegmon
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capable of being transmitted through
the offspring of flies.
P. sergenti Transmitter of kala-azar
in the Middle East and India.
P. verrucarum The transmitter of
Bartonella bacilliformis, causative
agent of Oroya fever (Carrion’s disease),
in South America.
phlebotomy (flĕ-bŏt⬘ō-mē) [⬙ ⫹ tome,
incision] The puncturing of a vein, or
the surgical opening of a vein, to withdraw blood. SEE: illus.
BLOOD DRAWING FROM THE
ANTECUBITAL VEIN
phlebovirus (flē⬘bō-vı̄-rŭs) A genus of
RNA viruses, transmitted to people by
the bite of infected insects. Common examples include Rift Valley fever virus
and Toscana virus. Phleboviruses can
cause hemorrhagic fevers, meningitis,
and meningoencephalitis, among other
illnesses. SEE: virus, Toscana.
phlegm (flĕm) [Gr. phlegma] 1. Thick
mucus, esp. that from the respiratory
passages. 2. One of the four “humors” of
early physiology.
phlegmasia (flĕg-mā⬘zē-ă) [Gr. phlegmasia] Inflammation.
p. alba dolens A complication of deep
venous thrombosis of the iliofemoral
veins in which the affected leg becomes
extremely pale, swollen, and tender.
SYN: milk leg; white leg. SEE: deep venous thrombosis.
cellulitic p. Septic inflammation of
the connective tissue of the leg following
childbirth.
p. cerulea dolens A complication of
deep venous thrombosis of the iliofemoral veins, in which the entire limb distal to the clot becomes swollen, purple,
and painful.
phlegmatic (flĕg-măt⬘ı̆k) [Gr. phlegmatikos] Of sluggish or dull temperament;
apathetic.
phlegmon (flĕg⬘mŏn) [Gr. phlegmone,
inflammation] Acute suppurative inflammation of subcutaneous connective
tissue, esp. a pyogenic inflammation
that spreads along fascial planes or
other natural barriers.
diffuse p. Diffuse inflammation of
subcutaneous tissues with sepsis.
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phlegmon
1775
gas p. Gas gangrene.
phlegmonous (flĕg⬘mŏn-ŭs) Pert. to inflammation of subcutaneous tissues.
(flē⬘ŭm prā-tĕn⬘sē)
The scientific name for a common North
American grass. Allergens derived from
this grass cause seasonal allergies, esp.
during the summer. SYN: timothy
grass.
phlorhizin
(flō-rı̄⬘zı̆n)
A glycoside
present in the bark of some fruit trees.
It is a powerful inhibitor of sugar transport in some animals.
phlyctena (flı̆k-tē⬘nă) pl. phlyctenae
[Gr. phlyktaina] A vesicle, esp. one of
many after a first-degree burn.
phlyctenar (flı̆k⬘tĕ-năr) Concerning a
vesicle.
phlyctenular (flı̆k-tĕn⬘ū-lăr) Resembling
or pert. to vesicles or pustules.
phlyctenule, phlyctenula (flı̆k⬘tĕn-ūl)
[Gr. phlyktaina, a blister; L. phlyctenula] A small vesicle or blister infiltrated by lymphocytes, as on the cornea
or conjunctiva.
phobia (fō⬘bē-ă) [Gr. phobos, fear] Any
persistent and irrational fear of a specific object, activity, or situation that results in a compelling desire to avoid the
feared stimulus. SEE: Nursing Diagnoses Appendix; Phobias Appendix.
social p. Persistent irrational fear of,
and the need to avoid, any situation in
which one might be exposed to potentially embarrassing or humiliating scrutiny by others. Even the anticipation of
a phobia-producing situation, such as
speaking or eating in public, socializing,
or using a public toilet, may cause anxiety or terror. Cognitive therapies, desensitization, relaxation therapy, selective serotonin-reuptake inhibitors, and
beta-blocking drugs such as atenolol are
used to treat this condition.
-phobia [Gr.] Combining form used as a
suffix indicating fear, aversion.
phobic (fō⬘bı̆k) [Gr. phobos, fear] Concerning a phobia.
phocomelia (fō⬙kō-mē⬘lē-ă) [Gr. phoke,
seal, ⫹ melos, limb] A congenital malformation in which the proximal portions of the extremities are poorly developed or absent. Thus the hands and
feet are attached to the trunk directly or
by means of a poorly formed bone. In
some cases this condition was due to the
pregnant woman taking thalidomide, a
sleeping pill, during early pregnancy.
That drug is no longer approved for such
use. SYN: amelia.
phocomelus (fō-kŏm⬘ĕ-lŭs) A person
with phocomelia.
phon- SEE: phono-.
phonacoscope
(fō-năk⬘ō-skōp)
[Gr.
phone, voice, ⫹ skopein, to examine]
A device for amplifying the percussion
note or voice sounds.
phonacoscopy (fō-nă-kŏs⬘kō-pē) Exam-
Phleum pratense
phonology
ination of the chest with a phonacoscope.
phonal (fō⬘năl) [Gr. phone, voice] Concerning the voice.
phonasthenia (fōn-ăs-thē⬘nē-ă) [⬙ ⫹
asthenia, weakness] Vocal weakness or
hoarseness caused by straining the
voice.
phonation (fō-nā⬘shŭn) The production
of sounds used in speech.
phone (fōn) [Gr. phone, voice] A single
speech sound.
cell p. A portable telephone, used, for
example, in ambulance-to-hospital communications and in 12-lead electrocardiogram transmission in some emergency medical systems.
phoneme (fō⬘nēm) [Gr. phonema, an utterance] In linguistics, the smallest
unit of speech that distinguishes one
sound from another.
phonendoscope (fō-nĕn⬘dō-skōp) [Gr.
phone, voice, ⫹ endon, within, ⫹ skopein, to examine] A stethoscope that intensifies sounds.
phonetics (fō-nĕt⬘ı̆ks) [Gr. phonetikos,
spoken] The science of speech and pronunciation. SYN: phonology.
phoniatrics (fō⬙nē-ăt⬘rı̆ks) [Gr. phone,
voice, ⫹ iatrikos, treatment] The
study of the voice and treatment of its
disorders.
phonic (fŏ⬘nı̆k) Concerning the voice or
sound.
phonism (fō⬘nı̆zm) [⬙ ⫹ −ismos, condition] An auditory sensation occurring
when another sense is stimulated. SEE:
synesthesia.
phono- [Gr. phone, voice] Combining
form indicating sound, voice.
phonocardiogram (fō⬙nō-kăr⬘dē-ō-grăm)
[⬙ ⫹ kardia, heart, ⫹ gramma, something written] A graphic recording of
the heart sounds.
phonocardiography (fō⬙nō-kăr⬙dē-ŏg⬘răfē) [⬙ ⫹ ⬙ ⫹ graphein, to write] The
mechanical or electronic registration of
heart sounds.
phonocatheter (fō⬙nō-kăth⬘ĕ-tĕr) [⬙ ⫹
katheter, something inserted] A catheter with a microphone at its end.
phonogram
(fō⬘nō-grăm)
[⬙
⫹
gramma, something written] A graphic
curve indicating the intensity and duration of a sound.
phonograph (fō⬘nō-grăf) [⬙ ⫹ graphein,
to write] An instrument used for the reproduction of sounds recorded on vinyl.
phonological disability (fō⬙nă-lŏj⬘ı̆-kăl,
fŏn⬙) Developmental phonological disorders.
phonological disorder A disorder in
which the individual does not use
speech sounds that are appropriate for
age and dialect. The disorder may involve production, use, organization, or
omission of sounds.
phonology (fō-nŏl⬘ō-jē) [⬙ ⫹ logos,
word, reason] Phonetics.
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phonomassage
1776
phonomassage (fō⬙nō-mă-sahzh⬘) [Gr.
phone, voice, ⫹ massein, to knead]
Exciting movements of the ossicles of
the ear by means of noise or alternating
suction and pressure directed through
the external auditory meatus.
phonometer (fō-nŏm⬘ĕ-tĕr) [⬙ ⫹ metron, measure] A device for determining
the intensity of vocal sounds.
phonomyoclonus (fō⬙nō-mı̄-ŏk⬘lō-nŭs) [⬙
⫹ mys, muscle, ⫹ klonos, a contraction] Invisible fibrillary muscular contractions revealed by auscultation.
phonomyogram (fō⬙nō-mı̄⬘ō-grăm) [⬙ ⫹
⬙ ⫹ gramma, something written] A
recording of sound produced by the action of a muscle.
phonomyography (fō⬙nō-mı̄-ŏg⬘ră-fē) [⬙
⫹ ⬙ ⫹ graphein, to write] The recording of sounds made by contracting muscular tissue.
phonopathy (fō-nŏp⬘ă-thē) [⬙ ⫹ pathos,
disease, suffering] Any disease of organs affecting speech.
phonophobia (fō⬙nō-fō⬘bē-ă) [⬙ ⫹ phobos, fear] 1. A morbid fear of sound or
noise. 2. A fear of speaking or hearing
one’s own voice.
phonophoresis (fō-nō-fŏr-ē⬘sı̆s) The use
of ultrasound to introduce medication
into a tissue. This has been used in
treating injuries to soft tissues. Not all
medicines are suitable for application
using this technique.
The use of phonophoresis should be
supervised by persons skilled in using the technique.
phonopsia (fō-nŏp⬘sē-ă) [⬙ ⫹ opsis, vi-
sion] The subjective perception of sensations upon hearing certain sounds.
phonoreceptor (fō-nō-rē-sĕp⬘tŏr) A receptor for sound waves.
-phoresis (fō-rē⬘sı̆s) [Gr. phoresis, being
borne] Suffix indicating transmission,
as electrophoresis, cataphoresis, anaphoresis.
-phoria [Gr. phoresis, being borne] In
ophthalmology, a combining form
meaning a turning, with reference to
the visual axis, such as cyclophoria.
Phormia (for⬘mē-ă) A genus of blowflies
belonging to the family Calliphoridae.
Their larvae normally live in decaying
flesh of dead animals, but they may infest neglected wounds or sores, giving
rise to myiasis.
phorozoon (fō⬙rō-zō⬘ŏn) [Gr. phoros,
fruitful, ⫹ zoon, animal] An asexual
stage of a multistage animal life cycle.
phose (fōz) [Gr. phos, light] A subjective sensation of light or color. SEE:
chromophose; erythrophose.
phosgene (fŏs⬘jēn) [⬙ ⫹ genes, born]
Carbonyl chloride, COCl2, a poisonous
gas that causes nausea and suffocation
when inhaled; used in chemical warfare.
phosphaturia
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phosphagen (fŏs⬘fă-jĕn) Several chemicals, including phosphocreatine, that release energy when split. They are highenergy phosphate compounds.
phosphatase (fŏs⬘fă-tās) One of a group
of enzymes that catalyze the hydrolysis
of phosphoric acid esters. They are of
importance in absorption and metabolism of carbohydrates, nucleotides, and
phospholipids and are essential in the
calcification of bone.
acid p. A phosphatase whose optimum pH is between 4.0 and 5.4. It is
present in kidney, semen, serum, and
prostate gland, and particularly in osteoclasts or odontoclasts in which it is
associated with demineralization or resorption of bone and teeth.
alkaline p. An enzyme whose optimal pH is about 9.8. It is present in the
liver, kidneys, intestines, teeth, plasma,
and developing bone. Alkaline phosphatase levels greater than 300% of normal
usually signify cholestatic disorders like
obstructive jaundice or intrahepatic biliary disease.
CDc25 p. A group of intracellular enzymes that regulate cell division, some
of which may contribute to the conversion of normal cells to cancer cells.
phosphate (fŏs⬘fāt) [Gr. phosphas] Any
salt of phosphoric acid containing the
radical PO4. Phosphates are important
in the maintenance of the acid-base balance of the blood, the principal ones being monosodium and disodium phosphate. The former is acid, the latter
alkaline. In the blood, because of their
low concentration, they exert a minor
buffering action.
acid p. A phosphate in which only
one or two hydrogen atoms of phosphoric acid have been replaced by a
metal.
calcium p. Any one of three salts of
calcium and phosphate; used as an antacid and dietary supplement.
creatine p. Phosphocreatine.
triple p. Calcium, ammonium, and
magnesium phosphate.
phosphate-bond energy Energy derived
from phosphorylated compounds such
as adenosine triphosphate (ATP) and
creatine phosphate.
phosphatemia
(fŏs⬙fă-tē⬘mē-ă)
[Gr.
phosphas, phosphate, ⫹ haima, blood]
Phosphates in the blood.
phosphatide (fŏs⬘fă-tı̄d) Phospholipid.
phosphatidylcholine (fŏs-fă-tı̄⬘dăl-kō⬘lı̆n,
lēn) [⬙ ⫹ ⬙] Lecithin.
phosphatidyl glycerol
(fŏs-fă-tı̄⬘dı̄l)
ABBR: PG. A phospholipid found in
amniotic fluid, pulmonary effluent, and
semen. It first appears in amniotic fluid
during week 36 of pregnancy, confirms
fetal gestational age, and is an accurate
predictor of fetal lung maturity.
phosphaturia (fŏs⬙fă-tū⬘rē-ă) [⬙ ⫹
ouron, urine] An excessive amount of
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phosphene
1777
phosphates in the urine; often causing
renal stones. SYN: phosphoruria; phosphuria.
SYMPTOMS: This condition is characterized by cloudy, opaque, alkaline,
and pale urine and pearly or pink-white
deposits of phosphates in standing
urine.
phosphene (fŏs⬘fēn) [Gr. phos, light, ⫹
phainein, to show] A sensation of light
caused by electrical or mechanical stimulation of the retina.
accommodation p. Phosphene resulting from contraction of the ciliary
muscles in accommodation. This is seen
esp. in the dark.
phosphide (fŏs⬘fı̄d) [⬙ ⫹ phorein, to
carry] A binary compound of phosphorus with an element or radical.
aluminum p. A pesticide used to protect stored grains from insects and rodents. After exposure to water it is converted to hydrogen phosphide, a poison
that inhibits cellular oxidative metabolism, esp. in metabolically active organs. It may be toxic or deadly to humans if ingested or inhaled. Its
chemical formula is AlP.
TREATMENT: There is no specific antidote. Cardiopulmonary support is
given to intoxicated patients.
hydrogen p. A poison that is released when phosphide pesticides react
with water. It inhibits oxidative metabolism in cells and may be deadly if eaten
or inhaled. Chemical formula is PH3.
SYN: phosphine.
zinc p. A toxic pesticide that releases
hydrogen phosphide after exposure to
water. Its chemical formula is Zn3P2.
phosphine Hydrogen phosphide.
phosphite (fŏs⬘fı̄t) A salt of phosphoric
acid.
phosphoamidase (fŏs⬙fō-ăm⬘ı̆-dās) An
enzyme that catalyzes the conversion of
phosphocreatine to creatine and orthophosphate.
phosphocholine (fŏs-fō-kō⬘lı̆n, lēn) [Fm.
phospho(rus) ⫹ ⬙] ABBR: Pcho. A
choline metabolite.
phosphocreatine (fŏs⬙fō-krē⬘ă-tı̆n) A
compound found in muscle. It is important as an energy source, yielding phosphate and creatine in this process, and
releasing energy that is used to synthesize adenosine triphosphate. SYN: creatine phosphate.
phosphodiesterase (fŏs-fō-dı̄-ĕs⬘tĕr-ās)
An enzyme critical for the breakdown of
cyclic adenosine monophosphate.
phosphodiesterase inhibitor
ABBR:
PDE inhibitor. Any agent that blocks
phosphodiesterase, inhibiting the production of second messengers within
cells, such as cyclic adenosine monophosphate or cyclic glucose monophosphate. Drugs that inhibit PDE include
sildenafil, an agent used to treat erectile
dysfunction, and other agents used as
phosphorism
positive inotropes and vasodilators in
heart failure.
phosphofructokinase
(fŏs⬙fō-frŭk⬙tōkı̄⬘nās) A glycolytic enzyme that catalyzes phosphorylation of fructose-6phosphate by adenosine triphosphate.
phosphofructokinase deficiency An autosomal recessive disorder in which a
deficiency in phosphofructokinase results in muscular weakness, exercise intolerance, hemolysis, hyperuricemia,
and myoglobinuria.
phospholipase (fŏs⬙fō-lı̆p⬘ās) An enzyme
that catalyzes hydrolysis of a phospholipid.
phospholipid (fŏs⬙fō-lı̆p⬘ı̆d) [Gr. phos,
light, ⫹ phorein, to carry, ⫹ lipos,
fat] A diglyceride containing phosphorus, such as lecithin. The lipid portion
of cell membranes is primarily phospholipids. SYN: phosphatide; phospholipin.
phospholipin (fŏs⬙fō-lı̆p⬘ı̆n) Phospholipid.
phosphonecrosis (fŏs⬙fō-nĕ-krō⬘sı̆s) [⬙
⫹ phorein, to carry, ⫹ nekros, dead,
⫹ osis, condition] Necrosis of the alveolar process in persons working with
phosphorus.
phosphonuclease (fŏs⬙fō-nū⬘klē-ās) An
enzyme that catalyzes the hydrolysis of
nucleotides to nucleosides and phosphoric acid.
phosphopenia (fŏs⬙fō-pē⬘nē-ă) [⬙ ⫹
phorein, to carry, ⫹ penia, lack] A deficiency of phosphorus in the body.
phosphoprotein (fŏs⬙fō-prō⬘tē-ı̆n) [⬙ ⫹
⬙ ⫹ protos, first] One of a group of proteins in which the protein is combined
with a phosphorus-containing compound. Caseinogen and vitellin are examples. Phosphoprotein was formerly
called nucleoalbumin.
phosphor (fŏs-fŏr) A substance in radiographic intensifying screens, fluoroscopic image intensifiers, or other image
receptors that convert photons of energy
into light, thereby amplifying the image.
rare earth p. An element such as yttrium, gadolinium, or lanthanum, that
is used for ultra-high-speed radiographic intensification screens.
phosphorated (fŏs⬘fō-rā⬙tĕd) [⬙ ⫹ phorein, to carry] Impregnated with phosphorus.
phosphorescence (fŏs-fō-rĕs⬘ĕns) The
induced luminescence that persists after cessation of the irradiation that
caused it; the emission of light without
appreciable heat.
phosphoribosyltransferase (fŏs⬙fō-rı̄⬙bōsı̆l-trăns⬘fĕr-ās) An enzyme that catalyzes reconversion to the ribonucleotide
stage of the purine bases, hypoxanthine
and guanine. The deficiency of this enzyme is inherited as an X-linked trait.
phosphorism (fŏs⬘for-ı̆zm) [⬙ ⫹ ⬙ ⫹
−ismos, condition] Chronic poisoning
from phosphorus.
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short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
phosphorolysis
phosphorolysis
photo-
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quite common. Yellow phosphorus is
also used in manufacturing fireworks
and fertilizers. SEE: Poisons and Poisoning Appendix.
SYMPTOMS: In this type of poisoning
acute irritation of the gastrointestinal
tract may be followed by liver failure.
Kidney damage also may occur. Other
symptoms include profound weakness,
hemorrhage, and heart failure. Occasionally nervous system symptoms predominate.
PATIENT CARE: Gastric lavage is
performed if phosphorus was swallowed. The airway is protected by cuffed
endotracheal intubation. Charcoal and
a cathartic drug are administered. Depending on the length of time since ingestion, intravenous fluids may be used
to flush the poison out of the system by
diuresis. In some cases, peritoneal or
hemodialysis may be needed. The patient requires close monitoring for delayed effects for at least 24 hr. If the poison was intentionally ingested, the
patient is placed on suicide precautions
and referred for further psychological
counseling.
phosphoryl (fŏs⬘for-ı̆l) The radical
[PO] R.
phosphorylase (fŏs-for⬘ı̆-lās) An enzyme
that catalyzes the formation of glucose1-phosphate from glycogen.
phosphorylation (fŏs⬙for-ı̆-lā⬘shŭn) The
combining of a phosphate with an organic compound.
phosphuria (fŏs-fū⬘rē-ă) [Gr. phos, light,
⫹ phoros, a bearer, ⫹ ouron, urine]
Phosphaturia.
phot (fōt) [Gr. photos, light] ABBR: ph.
The unit of photochemical energy equal
to 1 lumen/cm2 or about 929 foot-candles.
phot- SEE: photo-.
photalgia (fō-tăl⬘jē-ă) [Gr. photos, light,
⫹ algos, pain] Pain produced by light.
photaugiaphobia
(fō-taw⬙jē-ă-fō⬘bē-ă)
[Gr. photaugeia, glare, ⫹ phobos, fear]
Intolerance of bright light.
photic (fō⬘tı̆k) 1. Concerning light. 2. In
biology, pert. to the production of light
by certain organisms.
p. driving Exposing a subject to
flashing lights during an EEG (electroencephalographic) recording.
p. sneezing Sneezing initiated or
hastened in its onset by light stimulus.
It is sometimes due to light causing
tears, which, upon draining into the nasal area, cause sneezing. SYN: photoptarmosis.
photism (fō⬘tı̆zm) [⬙ ⫹ −ismos, condition] A subjective sensation of color or
light produced by a stimulus of another
sense, such as smell, hearing, taste, or
touch. SEE: synesthesia.
photo- [Gr. photos] Combining form indicating light.
short
standard
1778
(fŏs⬙fō-rŏl⬘ı̆-sı̆s)
The
chemical reaction of incorporating phosphoric acid into a molecule.
phosphorous acid (fŏs-fō⬘rŭs, fŏs⬘for-ŭs)
[⬙ ⫹ phoros, carrying] H3PO3; a crystalline acid formed when phosphorus is
oxidized in moist air.
phosphoruria (fŏs⬙for-ū⬘rē-ă) [⬙ ⫹
phorein, to carry, ⫹ ouron, urine]
Phosphaturia.
phosphorus (fŏs⬘fă-rŭs) [Gr. phos, light,
⫹ phoros, carrying] SYMB: P. A nonmetallic element not found in a free
state but in combination with oxygen
and cations such as calcium, sodium,
and potassium; atomic weight 30.9738;
atomic number 15. The normal serum
value of phosphorus is 2.5 to 4.5 mg/dl.
Normally, plasma concentrations of
phosphorus and calcium have a reciprocal relationship: as one increases, the
other decreases.
The adult body contains from 600 to
900 g of phosphorus in various forms:
70% to 80% in bones and teeth, principally combined with calcium; 10% in
muscle; and 1% in nerve tissue. Minimum daily requirement is approx. 800
mg. This amount should be increased
during pregnancy and lactation. Vitamin D is important in the absorption
and metabolism of phosphorus. Excess
phosphorus is excreted by the kidneys
and intestines, about 60% being excreted in urine principally as phosphates. Phosphorus deficiency is characterized by impaired appetite, weight
loss, retarded growth, weakness, and
malformation of bones and teeth. Bony
malformation resulting from disorders
of phosphorus metabolism is known either as rickets or osteomalacia.
Phosphorus compounds are found in
the nucleic acids DNA and RNA; in
adenosine triphosphate, the principal
energy source in cells; and in phosphocreatine, a secondary energy source for
muscle contraction.
ETIOLOGY: Deficiencies or excesses
of serum phosphorus are caused most
often by abnormalities in the excretion
of phosphorus by the kidneys.
SOURCES: Phosphorus is found in
many foods. Excellent sources are almonds, beans, barley, bran, cheese, cocoa, chocolate, eggs, lentils, liver, milk,
oatmeal, peanuts, peas, rye, walnuts,
and whole wheat. Good sources are asparagus, beef, cabbage, carrots, celery,
cauliflower, chard, chicken, clams, corn,
cream, cucumbers, eggplant, fish, figs,
meat, prunes, pineapples, pumpkin, raisins, and string beans.
p. poisoning Poisoning caused by the
ingestion of substances containing yellow phosphorus, such as rat and roach
poison. Before the introduction of safety
matches (which contain no yellow phosphorus), phosphorus poisoning was
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
photoactinic
1779
photoactinic (fō⬙tō-ăk-tı̆n⬘ı̆k) Emitting
both luminous and actinic rays.
photoaging Skin damage as a result of
exposure to ultraviolet rays. SYN: dermatoheliosis.
photoallergy (fō⬙tō-ăl⬘ĕr-jē) [Gr. photos,
light, ⫹ allos, other, ⫹ ergon, work]
A contact dermatitis produced by the interaction between ultraviolet light rays
and topically applied chemicals such as
sunscreens, perfumes, phenothiazines,
sulfonamides, and some components in
soaps. Sunlight changes the structure of
these chemicals, causing them to become allergens. An eczematous rash results. Avoiding the inciting agent is preventive; topical corticosteroid drugs
provide relief from the rash. SEE: persistent light reaction; photosensitivity;
phototoxic.
photoautotrophic (fō⬙tō-aw⬙tō-trōf⬘ı̆k) [⬙
⫹ ⬙] Capable of synthesizing nutrients
from light and inorganic chemicals. Said
of certain microorganisms, such as bacteria that contain chlorophyll.
Photobacterium damsela
(fō⬙tō-băktēr⬘ē-ŭm dăm⬘sĕl-ă) [⬙ ⫹ ⬙] A gramnegative bacillus formerly classified in
the genus Vibrio. It is a cause of fulminant wound infections.
photobiology (fō⬙tō-bı̄-ŏl⬘ō-jē) [⬙ ⫹
bios, life, ⫹ logos, word, reason] The
study of the effect of light on living
things.
photobiomodulation [⫹ bios, Gr. life ⫹
modulation] The use of low-intensity
light, typically in the near-infrared region of the electromagnetic spectrum, to
stimulate body tissues, relieve inflammation and pain, improve wound healing, or regenerate damaged cells. It is
also known as low level laser therapy, or
cold laser therapy.
photobiotic (fō⬙tō-bı̄-ŏt⬘ı̆k) [⬙ ⫹ bios,
life] Capable of living only in the light.
photocarcinogenesis
(fō-tō-căr-sı̆n-ōjĕn⬘ĕ-sı̆s) Malignant skin damage
caused by exposure to ultraviolet rays.
photochemistry (fō⬙tō-kĕm⬘ı̆s-trē) [⬙ ⫹
chemeia, chemistry] The branch of
chemistry concerned with the effects of
light rays.
photochemotherapy
(fō-tō-kē-mōthĕr⬘ă-pē) The use of light and chemicals together to treat certain conditions,
such as psoriasis or cutaneous T cell
lymphoma.
extracorporeal p. The exposure of
blood that is temporarily removed from
the body to ultraviolet A radiation. This
is used to treat several diseases, including pemphigus vulgaris and cutaneous
T cell lymphoma.
Patients exposed to photosensitizing agents, such as psoralens in
conjunction with ultraviolet light, have an
increased risk of melanoma and squamous
cell carcinoma. They should be examined
photofluorography
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regularly so that any developing skin cancers will be detected early.
photochromogen
(fō-tō-krō⬘mō-jĕn) [⬙
⫹ chroma, color, ⫹ gennan, to produce] Certain microorganisms in which
a pigment develops when it is grown in
the presence of light, such as Mycobacterium kansasii.
photocoagulation
(fō-tō-kō-ăg-ūlā⬘shŭn) The use of intense light or laser to burn or destroy tissue under direct observation; used for treatment of
diabetic retinopathy and glaucoma.
panretinal p. ABBR: PRP. The use
of high-intensity light or laser to create
hundreds of tiny retinal burns outside
of the vascular arcades. This treatment
has been shown to produce regression of
abnormal blood vessels in patients with
proliferative retinopathy from diabetes
or retinal vein occlusion.
photodermatitis (fō⬙tō-dĕr-mă-tı̄⬘tı̆s) [⬙
⫹ dermatos, skin, ⫹ itis, inflammation] Sensitivity of the skin to light;
may be due to photoallergy or to phototoxic reaction.
photodynamic (fō⬙tō-dı̄-năm⬘ı̆k) [⬙ ⫹
dynamis, force] Pert. to the effects of
light on biological, chemical, or physical
systems.
p. therapy 1. In ophthalmology, the
use of laser-activated photosensitizing
drugs to treat a variety of tumors and
nonmalignant conditions such as agerelated macular degeneration. 2. A
method of treating cancer by using
light-absorbing chemicals that are selectively retained by malignant cells.
When these cells are exposed to light in
the visible range, the cancer cells are
killed. SYN: photoradiotherapy.
photodysphoria (fō⬙tō-dı̆s-for⬘ē-ă) [⬙ ⫹
dysphoria, distress] Photophobia.
photoelectric effect (fō⬙tō-ĕ-lĕk⬘trı̆k) An
interaction between x-rays and matter
in which the x-ray photon ejects an inner-shell electron, causing a cascade of
outer-shell electrons to fill the hole. The
changing of energy shells releases secondary radiation equal to the difference
in the binding energies. This absorption
reaction increases the patient dose and
creates contrast on the radiographic
film. It usually occurs at low photon energies.
photoelectricity (fō⬙tō-ē-lĕk-trı̆⬘sı̆-tē) [⬙
⫹ elektron, amber] Electricity formed
by the action of light.
photoelectron (fō⬙tō-ē-lĕk⬘trŏn) [⬙ ⫹
elektron, amber] An electron that is
ejected from its orbit around the nucleus of an atom by interaction with a
photon of energy (light, x-radiation, and
so on).
photoerythema (fō⬙tō-ĕr⬙ı̆-thē⬘mă) [⬙ ⫹
erythema, redness] Reddening of the
skin caused by light.
photofluorography (fō⬙tō-flū⬙ĕr-ŏg⬘ră-fē)
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
photogenic
photorejuvenation
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periodus, period] The daily duration of
exposure to light of a living thing.
photoperiodism (fō⬙tō-pēr⬘ē-ō-dı̆zm) [⬙
⫹ ⬙ ⫹ Gr. −ismos, condition] The periodic occurrence of biological phenomena in relationship to the presence or
absence of light. In most animals, the
sleep-wake cycle is a form of photoperiodism.
photophilic (fō-tō-fı̆l⬘ı̆k) [⬙ ⫹ philein, to
love] Seeking, or fond of, light.
photophobia (fō⬙tō-fō⬘bē-ă) [⬙ ⫹ phobos, fear] Unusual intolerance of light,
occurring in measles, rubella, meningitis, and inflammation of the eyes. SYN:
photodysphoria.
photophoresis (fō-tō-fŏr-ē⬘sı̆s) A technique
used in treating cutaneous T-cell lymphoma. It incorporates exposure of a lymphocyte-enriched blood fraction, obtained
by use of apheresis to ultraviolet A light
after the patient has ingested the cytotoxic agent 8-methoxypsoralen. SYN: extracorporeal photochemotherapy.
photopia (fō-tō⬘pē-ă) Adjustment of the
eye for vision in bright light; the opposite of scotopia.
photopsia, photopsy (fō-tŏp⬘sē-ă, fōtŏp⬘sē) [Gr. photos, light, ⫹ opsis, vision] The subjective sensation of
sparks or flashes of light in retinal, optic, or brain diseases.
photopsin (fō-tŏp⬘sı̆n) The protein portion (opsin) of the photopigments in the
cones of the retina.
photoptarmosis (fō⬙tō-tăr-mō⬘sı̆s) [⬙ ⫹
ptarmosis, sneezing] Photic sneezing.
photoptometer (fō-tŏp-tŏm⬘ĕ-tĕr) [⬙ ⫹
opsis, vision, ⫹ metron, measure] A
device for determining the smallest
amount of light that will make an object
visible.
photoradiometer (fō⬙tō-rā⬙dē-ŏm⬘ĕ-tĕr)
[⬙ ⫹ L. radius, ray, ⫹ Gr. metron,
measure] A device for determining the
ability of ionizing radiation to penetrate
substances.
photoradiotherapy (fō-tō-rā-dē-ō-thĕr⬘ăpē) Photodynamic therapy.
photoreaction (fō⬙tō-rē-ăk⬘shŭn) [⬙ ⫹
LL. reactus, reacted] A chemical reaction produced or influenced by light.
photoreactivation
(fō⬙tō-rē-ăk⬙tı̆vā⬘shŭn) Enzymatic repair of lesions
such as can be produced in DNA by ultraviolet light.
photoreception (fō⬙tō-rē-sĕp⬘shŭn) [⬙ ⫹
L. recipere, to receive] The perception
of light rays in the visible light spectrum.
photoreceptor (fō⬙tō-rē-sĕp⬘tor) Sensory
nerve endings or cells that are capable
of being stimulated by light. In humans,
these include the rods and cones of the
retina.
photorejuvenation
(fō⬙tō-rē-jū-vĕnā⬘shun) [Gr. photos, light, ⫹ L. re,
again, ⫹ juvenis, young] The cosmetic
short
standard
1780
Photographing the images seen during
fluoroscopic examination.
photogenic, photogenous (fō⬙tō-jĕn⬘ı̆k,
−tŏj⬘ĕn-ŭs) Induced by, or inducing,
light.
photokinetic (fō⬙tō-kı̆n-ĕt⬘ı̆k) [⬙ ⫹ kinetikos, motion] Reacting with motion
to stimulation by light.
photolabile (fō-tō-lā⬘bı̄l) The characteristic of being destroyed or inactivated by
light.
photoluminescence (fō⬙tō-lū-mı̆-nĕs⬘ĕns)
[⬙ ⫹ L. lumen, light] The power of an
object to become luminescent when
acted on by light.
photolysis (fō-tŏl⬘ı̆-sı̆s) [⬙ ⫹ lysis, dissolution] Dissolution or disintegration
under stimulus of light rays.
photomedicine (fō⬙tō-mĕd⬘ı̆-sı̆n) [⬙ ⫹ ⬙]
The use of light to treat certain conditions. SEE: hemolytic disease of the newborn; phototherapy; psoriasis.
photometer (fō-tŏm⬘ĕ-tĕr) [⬙ ⫹ metron,
measure] A device for measuring the
intensity of light.
photometry (fō-tŏm⬘ĕ-trē) Measurement of light rays.
photomicrograph (fō⬙tō-mı̄⬘krō-grăf) [⬙
⫹ mikros, small, ⫹ graphein, to
write] A photograph of an object under
a microscope.
photomultiplier tube (fō⬙tō-mŭl⬘tı̆-plı̄⬙ĕr)
ABBR: PMT. In radiography, an electronic vacuum tube designed to convert
light photons into electrical pulses. It is
used to digitize incoming light photons
prior to the creation of computerized images in nuclear medicine and other imaging modalities.
photon (fō⬘tŏn) [Gr. photos, light] A
light quantum or unit of energy of a
light ray or other form of radiant energy. It is generally considered to be a
discrete particle having zero mass, no
electric charge, and indefinitely long
life.
photo-onycholysis
(fō-tō-ŏ-nı̆-kō-lı̄⬘sı̆s)
Separation of the nail from the distal
nailbed in conjunction with sun exposure and simultaneous use of drugs
such as antibiotics.
photopatch testing (fō⬘tō-păch⬙) A test
used to identify allergic reactions triggered by ultraviolet (UV) light (specifically, to UVA).
PATIENT CARE: Two equivalent
samples of the putative allergen are
prepared. Each is applied to one side of
the upper back of the patient. One side
is shielded from exposure to ultraviolet
light, and the other is treated with UVA
at standardized doses and intervals.
The reactions of the skin on either side
are compared.
photoperceptive (fō⬙tō-pĕr-sĕp⬘tı̆v) [⬙ ⫹
L. percipere, to receive] Capable of perceiving light.
photoperiod (fō⬙tō-pēr⬘ē-ŏd) [⬙ ⫹ L.
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
1781
photoretinitis
repair of skin damaged by sunlight or
other ultraviolet radiation. It may involve dermabrasion, chemical peels, or
pulsed-light therapy.
photoretinitis (fō⬙tō-rĕt⬙ı̆-nı̄⬘tı̆s) [Gr.
photos, light, ⫹ L. retina, retina, ⫹
Gr. itis, inflammation] Damage to the
macula of the eye owing to exposure to
intense light. SEE: blindness, eclipse.
photoscan (fō⬘tō-skăn⬙) A representation of the concentration of a radioisotope outlining an organ in the body. The
map is printed on photographic paper.
SEE: scintiscan.
photosensitivity (fō⬙tō-sĕn⬙sı̆-tı̆v⬘ı̆-tē) [⬙
⫹ ⬙] Sensitivity to light either because
of an autoimmune illness (e.g., systemic
lupus erythematosus), or because of the
use or application of sensitizing drugs or
chemicals.
DRUG-INDUCED PHOTOSENSITIVITY:
Individuals using certain drugs or other
chemicals may develop dermatitis or
sunburn after exposure to light of an intensity or duration that normally would
not have affected them. These phototoxic reactions result from interaction
between ultraviolet light and chemicals
contained in the drug, but are not mediated by the immune system. Agents
associated with photosensitizing reactions include coal tar derivatives found
in perfumes and dyes, antiemetics, estrogens and progestins, psoralens, sulfonamides, sulfonylureas (oral hypoglycemic agents), thiazide diuretics, and
tetracyclines. Persons known to have increased sensitivity to light caused by
the medications they are taking should
avoid exposure to sunlight or, when in
the sun, should use sunscreens or clothing to cover exposed areas of the skin.
SEE: photoallergy.
photosensitization
(fō⬙tō-sĕn⬙sı̆-tı̆zā⬘shŭn) A condition in which the skin
reacts abnormally to light, esp. ultraviolet radiations or sunlight. It is due to
the presence of drugs, hormones, or
heavy metals in the system. SEE: photoallergy.
photosensitizer (fō⬙tō-sĕn⬘sı̆-tı̄⬙zĕr) A
substance that, in combination with
light, will cause a sensitivity reaction in
the substance or organism.
photosensor (fō⬘tō-sĕn⬙sĕr) A device
that detects light.
photostable (fō⬘tō-stā⬙b’l) [⬙ ⫹ L. stabilis, stable] Uninfluenced by exposure
to light.
photostimulable
phosphor
system
ABBR: PSP system. Filmless radiography; i.e., a radiographic system that
stores image data as electron charges on
a cassette (an imaging plate). When
scanned by a laser, the stored charges
emit light whose intensities can be digitized and displayed as a radiograph.
The cassette, unlike an exposed film, is
reusable.
phren-
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photostimulate To energize (or encourage a response in) a substance with light
or x-rays. photostimulable, adj.
photosynthesis (fō⬙tō-sı̆n⬘thĕ-sı̆s) [⬙ ⫹
synthesis, placing together] The process by which plants manufacture carbohydrates and oxygen by combining
carbon dioxide and water, using light
energy in the presence of chlorophyll.
phototaxis (fō⬙tō-tăk⬘sı̆s) [Gr. photos,
light, ⫹ taxis, arrangement] The reaction and movement of cells and microorganisms under the stimulus of light.
phototest (fō⬘tō-tĕst⬙) The use of controlled exposures to ultraviolet light
(and ambient or polychromatic light) to
determine the cause, or presence of, a
rash, thought to be triggered by sunlight exposure.
phototherapy (fō⬙tō-thĕr⬘ă-pē) [⬙ ⫹
therapeia, treatment] Exposure to sunlight or to ultraviolet (UV) light for therapeutic purposes. One example of phototherapy is the treatment of neonatal
jaundice, in which the jaundiced infant
is exposed to UV light to decrease bilirubin levels in the bloodstream, thereby
reducing the risk of bilirubin deposition
in the brain. Phototherapy also is used
to treat some skin diseases, including
cutaneous T-cell lymphoma and psoriasis, and to relieve the symptoms of seasonal affective disorder. SYN: light therapy. SEE: photodynamic therapy;
seasonal affective disorder.
The eyes and often the gonads of
treated patients are shielded from
the light source to prevent them from being damaged.
(fō⬙tō-thĕr⬘măl) [⬙ ⫹
therme, heat] Concerning heat produced by light.
photothermolysis, selective (fō-tō-thĕrmă⬘lı̆-sı̆s) The use of short pulses of
light to treat skin conditions. This
method causes less damage to normal
tissue than do continuous beam lasers.
SEE: laser.
phototimer (fō⬘tō-tı̄m⬙ĕr) SEE: control,
automatic exposure.
phototoxic (fō⬙tō-tŏk⬘sı̆k) [⬙ ⫹ toxikon,
poison] Pert. to the harmful reaction
produced by light energy, esp. that produced in the skin. Simple sunburn of the
skin is an example of phototoxicity.
phototrophic (fō⬙tō-trŏf⬘ı̆k) [⬙ ⫹ trophe,
nutrition] Concerning the ability to use
light in metabolism.
phototropism (fō-tŏt⬘rō-pı̆zm) [⬙ ⫹ tropos, turning, ⫹ -ismos, condition] A
tendency exhibited by green plants and
some microorganisms to turn toward or
grow toward light.
photuria (fō-tū⬘rē-ă) [⬙ ⫹ ouron, urine]
Excretion of phosphorescent urine.
phren- SEE: phreno-.
photothermal
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
phrenalgia
phrenalgia
physiatrist
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these compounds may have carcinogenic, endocrine disruptive, or other
toxic effects on adults or the developing
fetus.
Phthirus (thı̆r⬘ŭs) [Gr. phtheir, louse] A
genus of sucking lice belonging to the order Anoplura.
P. pubis The crab louse. It infests primarily the pubic region but it may also
be found in armpits, beard, eyebrows,
and eyelashes. SEE: pediculosis pubis.
phthisis A wasting illness.
p. bulbi The wasting of ocular tissue.
phyco- [Gr. phykos, seaweed] Combining form meaning seaweed.
phycology (fı̄-kŏl⬘ō-jē) [Gr. phykos, seaweed, ⫹ logos, word, reason] The
study of algae.
phycotoxin (fı̄⬙kō-tŏk⬘sı̆n) [⬙ ⫹ ⬙] Any
natural poison produced by algae, e.g.,
marine phytoplankton. Examples of
phycotoxins include okadaic acid, domoic acid, and yessotoxin.
phylactic (fı̆-lăk⬘tı̆k) [Gr. phylaktikos,
preservative] Concerning or producing
phylaxis.
phylaxis (fı̆-lăk⬘sı̆s) [Gr., protection]
The active defense of the body against
infection.
phyletic (fı̆-lĕt⬘ı̆k) [Gr. phyletikos] Phylogenetic.
phylloquinone (fı̆l⬙ō-kwı̆n⬘ōn) Phytonadione.
phylogenesis (fı̄⬙lō-jĕn⬘ĕ-sı̆s) [Gr. phyle,
tribe, ⫹ genesis, generation, birth]
The evolutionary development of a
group, race, or species. SEE: phylogeny.
phylogenetic (fı̄⬙lō-jĕ-nĕt⬘ı̆k) Concerning
the development of a race or phylum.
SYN: phyletic.
phylogeny (fı̄-lŏj⬘ĕ-nē) Development and
growth of a race or group of animals.
SEE: ontogeny.
phylum (fı̄⬘lŭm) pl. phyla [Gr. phylon,
tribe] In taxonomy, one of the primary
divisions of a kingdom, one division
higher than a class.
physaliform, physalliform (fı̆-săl⬘ı̆-form)
[Gr. physallis, bubble, ⫹ L. forma,
shape] Resembling a bleb or bubble.
physaliphorous (fı̆s⬙ă-lı̆f⬘ō-rŭs) Pert. to a
highly vacuolated cell present in a chordoma.
physalis (fı̆s⬘ă-lı̆s) [Gr. physallis, bubble]
A large vacuole present in the cell of certain malignancies such as a chondroma.
Physaloptera (fı̆s⬙ă-lŏp⬘tĕr-ă) [⬙ ⫹
pteron, wing] A genus of nematode
worms belonging to the suborder Spiruata.
P. caucasica A species that occurs in
and damages the upper gastrointestinal
tract.
physiatrics (fı̆z⬙ē-ăt⬘rı̆ks) [Gr. physis, nature, ⫹ iatrikos, treatment] The curing of disease by natural methods, esp.
physical therapy.
physiatrist (fı̆z⬙ē-ăt⬘rı̆st) A physician
who specializes in physical medicine.
short
standard
1782
(frĕ-năl⬘jē-ă) [Gr. phren,
mind, diaphragm ⫹ algos, pain]
1. Pain of functional origin. 2. Pain in
the diaphragm.
phrenectomy
(frĕ-nĕk⬘tō-mē)
[Gr.
phren, diaphragm, ⫹ ektome, excision]
1. Surgical excision of all or part of the
diaphragm. 2. Surgical resection of part
of the phrenic nerve.
phrenetic (frĕn-ĕt⬘ı̆k) [Gr. phren, mind]
1. Maniacal; frenzied. 2. A maniac.
-phrenia Combining form indicating
mental disorder.
phrenic (frĕn⬘ı̆k) [Gr. phren, diaphragm]
Concerning the diaphragm, as the
phrenic nerve.
phrenicectomy (frĕn-ı̆-sĕk⬘tō-mē) [Gr.
phren, diaphragm, ⫹ ektome, excision]
Phreniconeurectomy.
phreniconeurectomy
(frĕn⬙ı̆-kō-nūrĕk⬘tō-mē) [⬙ ⫹ neuron, nerve, ⫹ ektome, excision] Excision of part of the
phrenic nerve.
phrenicotomy (frĕn⬙ı̆-kŏt⬘ō-mē) [⬙ ⫹
tome, incision] Cutting of the phrenic
nerve to immobilize a lung by inducing
paralysis of one side. This causes the diaphragm to rise, compressing the lung
and diminishing respiratory movement,
thus resting the lung on that side.
phreno-, phren- [Gr. phren, mind; L.
phrenicus, diaphragm] 1. Combining
form meaning mind. 2. Combining form
meaning diaphragm.
phrenodynia
(frĕn⬙ō-dı̆n⬘ē-ă)
[⬙
⫹
odyne, pain] Pain in the diaphragm.
phrenogastric (frĕn⬙ō-găs⬘trı̆k) [⬙ ⫹
gaster, belly] Concerning the diaphragm and stomach.
phrenohepatic (frĕn⬙ō-hĕ-păt⬘ı̆k) [⬙ ⫹
hepar, liver] Concerning the diaphragm and liver.
phrenopericarditis
(frē⬙nō-pĕr⬙ı̆-kărdı̄⬘tı̆s) [Gr. phren, diaphragm, ⫹ peri,
around, ⫹ kardia, heart, ⫹ itis, inflammation] Attachment of the heart
by adhesions to the diaphragm.
phrenoplegia
(frĕn-ō-plē⬘jē-ă)
[Gr.
phren, mind, diaphragm ⫹ plege,
stroke] 1. A sudden attack of mental illness. 2. Paralysis of the diaphragm.
phrenoptosis (frĕn⬙ŏp-tō⬘sı̆s) [Gr. phren,
diaphragm, ⫹ ptosis, a dropping]
Downward displacement of the diaphragm.
phrenospasm (frĕn⬘ō-spăzm) [⬙ ⫹
spasmos, a convulsion] Spasm of the diaphragm.
phrenosplenic (frĕn⬙ō-splĕn⬘ı̆k) [⬙ ⫹
splen, spleen] Concerning the diaphragm and spleen.
phthalates (thăl⬘ātes) Chemical compounds used to improve the flexibility of
plastics. In health care, phthalates are
used in devices such as intravenous tubing. They are also used in numerous
consumer goods, including nail polish,
soaps, shampoos, and vinyl, among
many others. Some evidence suggests
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
physic
1783
physic (fı̆z⬘ı̆k) [Gr. physikos, natural]
1. An obsolete way to express the art of
medicine and healing. 2. An obsolete
term for a medicine, esp. a cathartic.
physical (fı̆z⬘ı̆-kăl) 1. Of or pert. to nature or material things. 2. Concerning
or pert. to the body; bodily.
p. activity and exercise A general
term for any sort of muscular effort but
esp. the kind intended to train, condition, or increase flexibility of the muscular and skeletal systems of the body.
p. examination Examination of the
body by auscultation, palpation, percussion, inspection, and olfaction.
p. fitness The ability to carry out
daily tasks with vigor and alertness,
without undue fatigue, and with ample
energy to enjoy leisure-time pursuits
and meet unforeseen emergencies. It is
the ability to withstand stress and persevere under difficult circumstances in
which an unfit person would quit. Implied in this is more than lack of illness;
it is a positive quality that everyone has
to some degree. Physical fitness is minimal in the severely ill and maximal in
the highly trained athlete. Persons who
maintain a high level of fitness may
have increased longevity as compared to
those who are sedentary. In addition,
the quality of life is enhanced in those
who are fit.
physical mobility, impaired A limitation
in independent, purposeful physical
movement of the body or of one or more
extremities. SEE: Nursing Diagnoses
Appendix.
physical therapist A licensed practitioner
of physical therapy who has graduated
from an accredited physical therapy education program. SYN: registered physical therapist.
physical therapist assistant ABBR: PTA.
A graduate of an accredited physical
therapist assistant education program.
The physical therapist assistant is a
paraprofessional who assists the physical therapist, providing selected interventions under the direction and supervision of the physical therapist.
physical therapy A profession that is responsible for management of the patient’s movement system. This includes
conducting an examination; alleviating
impairments and functional limitation;
preventing injury, impairment, functional limitation, and disability; and engaging in consultation, education, and
research. Direct interventions include
the appropriate use of patient education, therapeutic exercise, and physical
agents such massage, thermal modalities, hydrotherapy, and electricity.
SYN: physiotherapy.
physical therapy diagnosis 1. A clinical
classification of a patient’s impairments, functional limitations, and disabilities by a physical therapist. 2. The
physicist
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use of data obtained by physical therapy
examination and other relevant information to determine the cause and nature of a patient’s impairments, functional limitations, and disabilities.
physician (fı̆-zı̆sh⬘ŭn) [O.Fr. physicien]
A person who has successfully completed the prescribed course of studies
in medicine in a medical school officially
recognized by the country in which it is
located, and who has acquired the requisite qualifications for licensure in the
practice of medicine.
attending p. A physician who is on
the staff of a hospital and regularly
cares for patients therein.
family p. SEE: primary care p.
primary care p. ABBR: PCP. A physician to whom a family or individual
goes initially when ill or for a periodic
health check. This physician assumes
medical coordination of care with other
physicians for the patient with multiple
health concerns. A related term, primary care provider, includes both physicians and mid-level practitioners.
SYN: family physician.
resident p. A physician who works
full or part time in a hospital to continue
training after internship; commonly
called a resident.
physician assistant ABBR: PA. A specially trained and licensed individual
who performs tasks usually done by
physicians and works under the direction of a supervising physician. The PA
training programs are accredited by the
American Medical Association. All
states require PAs to pass the certification examination of the National Commission on Certification of Physician
Assistants.
physician orders for life-sustaining therapy ABBR: POLST. A part of a patient’s health record that specifies his or
her preferences regarding end-of-life
care, specifically directives regarding
life support, the use of antibiotics, artificial feeding, and medically administered hydration.
Physicians’ Desk Reference ABBR: PDR.
An annual compendium of information
concerning drugs, primarily prescription and diagnostic products. The information is largely that included by the
manufacturer in the labeling or package
insert as required by the Food and Drug
Administration: indications for use, effects, dosages, administration, warnings, hazards, contraindications, drug
interactions, side effects, and precautions.
physician shortage area A geographic region with an inadequate supply of physicians, usually one where more than
400 people live for each physician in residence.
physicist (fı̆z⬘ı̆-sı̆st) [L. physics, natural
short
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#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
physico-
1784
sciences] A specialist in the science of
physics.
physico- [Gr. physikos] Combining form
meaning physical, natural.
physicochemical (fı̆z⬙ı̆-kō-kĕm⬘ı̆-kăl) [⬙
⫹ chemeia, chemistry] Concerning the
application of the laws of physics to
chemical reactions.
physics (fı̆z⬘ı̆ks) [Gr. physis, nature]
The study of the laws of matter and
their interactions with energy. Included
are the fields of acoustics, optics, mechanics, electricity, thermodynamics,
and ionizing radiation.
physio- [Gr. physis] Combining form denoting nature.
physiochemical (fı̆z⬙ē-ō-kĕm⬘ı̆-kăl) [Gr.
physis, nature, ⫹ chemeia, chemistry]
Concerning clinical chemistry.
physiognomy
(fı̆z⬙ē-ŏg⬘nō-mē)
[Gr.
physis, nature, ⫹ gnomon, a judge]
1. The countenance. 2. Assumed ability
to diagnose a disease or illness based on
the appearance and expression(s) on the
face.
physiognosis (fı̆z⬙ē-ŏg-nō⬘sı̆s) [⬙ ⫹ gnosis, knowledge] Diagnosis determined
from one’s facial expression and appearance.
physiological
(fı̆z⬙ē-ō-lŏj⬘ı̆-kăl)
[Gr.
physis, nature, ⫹ logos, word, reason]
Concerning body function.
physiologically based pharmacokinetic
modeling ABBR: PBPK. A means of
assessing the behavior of various chemical compounds in living organisms
based upon their apparent absorption,
distribution, and elimination from the
body, and such in vitro characteristics
as their plasma protein binding and cell
membrane permeability. PBPK mathematical modeling is used in pharmacology to select promising new agents for
therapeutic use, and in toxicology to estimate the potential harm that chemicals may cause when ingested by animals or released into the environment.
physiologist (fı̆z⬙ē-ŏl⬘ō-jı̆st) One who
studies the functioning of the body.
physiology (fı̆z⬙ē-ŏl⬘ō-jē) [Gr. physis, nature, ⫹ logos, study] The science of
the functions of the living organism and
its components and of the chemical and
physical processes involved.
aviation p. The branch of physiology
that deals with conditions encountered
by humans in flying, mountain climbing, or space flight. The conditions studied are hypoxia, extreme temperature
and radiation, effects of acceleration
and deceleration, weightlessness, motion sickness, enforced inactivity, mental stress, acclimatization, and disturbance of biological rhythm.
cell p. The functioning of cells.
comparative p. The study and comparison of the physiology of different
species.
phytoestrogen
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general p. The broad scientific basis
of physiology.
pathologic p. The physiological explanation of pathologic events.
physiopathologic
(fı̆z⬙ē-ō-păth⬙ō-lŏj⬘ı̆k)
[⬙ ⫹ pathos, disease, suffering, ⫹ logos, word, reason] 1. Concerning physiology and pathology. 2. Pert. to a pathologic alteration in a normal function.
physiotherapy (fı̆z⬙ē-ō-thĕr⬘ă-pē) [⬙ ⫹
therapeia, treatment] Physical therapy.
decongestive p. Physical therapy
designed to mobilize localized collections of fluid, e.g., in lymphedema.
physique (fı̆-zēk⬘) [Fr.] Body build; the
structure and organization of the body.
physo- [Gr. physa, air] Combining form
indicating air, gas.
physometra (fı̄⬙sō-mē⬘tră) [⬙ ⫹ metra,
uterus] Air or gas in the uterine cavity.
physopyosalpinx (fı̄⬙sō-pı̄⬙ō-săl⬘pı̆nks) [⬙
⫹ pyon, pus, ⫹ salpinx, tube] Pus
and gas in a fallopian tube.
phytanic acid storage disease (fı̄-tăn⬘ı̆k)
Refsum’s disease.
phytase (fı̄⬘tās) [⬙ ⫹ ase, enzyme] An
enzyme found in grains and present in
the kidneys; important in splitting phytin or phytic acid into inositol and phosphoric acid.
phytin (fı̄⬘tı̆n) A calcium or magnesium
salt of inositol and hexaphosphoric acid,
present in cereals. SEE: inositol.
phyto-, phyt- [Gr. phyton] Combining
forms indicating plant, that which
grows.
phytoagglutinin (fı̄⬙tō-ă-gloo⬘tı̆-nı̆n) [Gr.
phyton, plant, ⫹ L. agglutinans, gluing] A lectin that agglutinates red
blood cells and leukocytes.
phytobezoar (fı̄⬙tō-bē⬘zor) [⬙ ⫹ Arabic
bazahr, protecting against poison] A
mass composed of vegetable matter
found in the stomach. SYN: food ball.
SEE: bezoar.
phytochemical (fı̄-tō-kĕm⬘ı̆-kăl) Any of
the hundreds of natural chemicals
present in plants. Many have nutritional value; others are protective (e.g.,
antioxidants) or cause cell damage (e.g.,
free radicals). Important phytochemicals include allyl sulfur, phytosterol, polyphenol, saponin, phenolic acids, protease inhibitors, carotenoids, capsaicin,
and lignans.
phytochemistry (fı̄⬙tō-kĕm⬘ı̆s-trē) [⬙ ⫹
chemeia, chemistry] The study of plant
chemistry.
phytodermatitis (fı̄⬙tō-dĕr⬙mă-tı̄⬘tı̆s) [⬙
⫹ ⬙] Allergic skin inflammation caused
by contact with plants or their extracts.
phytoestrogen (fı̄⬘tō-ĕs⬘trō-jĕn) Estrogen-like steroid compound found in
beans, sprouts, fruits, vegetables, cereals, and some nuts. Phytoestrogens are
being examined for their potential role
in the management of hormone-sensi-
short
standard
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phytogenous
1785
tive cancers, cardiovascular disease,
lipid disorders, and menopause.
phytogenous (fı̄-tŏj⬘ĕ-nŭs) [⬙ ⫹ gennan, to produce] Arising in or caused by
plants.
phytohemagglutinin (fı̄t⬙ō-hēm-ă-gloot⬘ı̆nı̆n) [⬙ ⫹ haima, blood, ⫹ L. agglutinare, to glue to] ABBR: PHA. A
chemical derived from red kidney
beans, used in the laboratory as a mitogen,
stimulating
T-lymphocyte
growth in cultures.
phytoid (fı̄⬘toyd) [⬙ ⫹ eidos, form,
shape] Plantlike.
phytonutrient (fı̄⬙tō-nūt⬘rē-ĕnt) A metabolically active or nourishing substance
derived from plants. Examples of phytonutrients are carotene, lutein, and lycopene.
phytopharmacology (fı̄⬙tō-făr⬙mă-kŏl⬘ōjē) [⬙ ⫹ pharmakon, drug, ⫹ logos,
word, reason] The study of drugs obtained from plants.
phytophotodermatitis
(fı̄⬙tō-fō⬙tōdĕr⬙mă-tı̄⬘tı̆s) [⬙ ⫹ photos, light, ⫹
derma, skin, ⫹ itis, inflammation] A
dermatitis produced by exposure to certain plants and then sunlight.
phytoprecipitin (fı̄⬙tō-prē-sı̆p⬘ı̆-tı̆n) A
precipitin produced by immunization
with a plant protein.
phytoremediation
(fı̄⬙tō-rĕ-mēd⬘ēā⬘shŭn) The use of trees and plants to
remove pollutants from the environment.
phytosis (fı̄-tō⬘sı̆s) [⬙ ⫹ osis, condition]
1. The presence of a plant parasite. 2. A
disease caused by a plant parasite.
phytosterol (fı̄⬙tō-stē⬘rŏl) Any sterol
present in vegetable oil or fat.
phytotherapy (fı̄⬘tō-thĕr⬙ă-pē) The use
of plant extracts in the maintenance of
health or the treatment of disease.
pI The pH of the isoelectric point of a substance in solution.
pia (pē⬘ă) [L.] Tender, soft.
pia-arachnitis (pē⬙ă-ăr⬙ăk-nı̄⬘tı̆s) Piarachnitis.
Piaget, Jean (pē-ă-zhā⬘) Swiss philosopher and psychologist, 1896– 1980,
whose work provided understanding of
how children’s thinking differs from
adults’ and of how children learn. Concerning education, he explained, “The
goal of education is not to increase the
amount of knowledge but to create the
possibilities for a child to invent and discover, to create men who are capable of
doing new things.”
pial (pı̄⬘ăl) Concerning the pia mater.
pia mater (pē⬘ă mā⬘tĕr) [L. pia, soft, ⫹
mater, mother] SEE: under mater.
pian (pē-ăn⬘) [Fr.] A contagious skin
disease of the tropics. SYN: yaws.
piarachnitis (pı̄⬙ăr-ăk-nı̄⬘tı̆s) [L. pia, tender, ⫹ Gr. arachne, spider, ⫹ itis, inflammation]
Inflammation of the
arachnoid and pia mater. SYN: leptomeningitis; pia-arachnitis.
pickwickian syndrome
top of rh
base of rh
piblokto, pibloktog (pı̆-blŏk⬘ tō) [Inuit]
A syndrome, apparently culturally specific for Eskimo women, in which the
person screams, removes or tears off her
clothes, and runs naked in the snow.
The woman then has no recollection of
these events.
pica (pı̄⬘kă) [L., magpie] An eating disorder manifested by a craving to ingest
any material not normally considered as
food, including starch, clay, ashes, toy
balloons, crayons, cotton, grass, cigarette butts, soap, twigs, wood, paper,
metal, or plaster. This condition is seen
in pregnancy, chlorosis, hysteria, helminthiasis, and certain psychoses. It
may also be associated with iron-deficiency anemia. The importance of this
condition, the etiology of which is unknown, stems from the toxicity of ingested material (e.g., paint that contains lead) or from ingesting materials
in place of essential nutrients. The inclusion of compulsive ingestion of nonfood and food items such as licorice,
croutons, chewing gum, coffee grounds,
or oyster shells as examples of pica is
controversial. SEE: appetite; geophagia;
taste.
PICC Peripherally inserted central venous
catheter.
pick 1. A sharp, pointed, curved dental
instrument used to explore tooth surfaces and restorations for defects. 2. To
remove bits of food from teeth.
Pick, Arnold (pı̆k) Czechoslovakian physician, 1851– 1924.
P.’s disease Dementia associated
with atrophy of the frontal and/or temporal lobes of the brain. The disease has
three variants: one in which affected patients develop a progressively worsening fluent aphasia; one in which aphasia
is not fluent; and one in which loss of
social skills and intellectual functions,
apathy, and disorientation are most
prominent. SYN: frontemporal dementia. SEE: Alzheimer’s disease.
Pick, Friedel (pı̆k) Czechoslovakian physician, 1867– 1926.
P.’s disease Chronic constrictive
pericarditis.
Pick, Ludwig (pı̆k) German physician,
1868– 1944.
P.’s cell A foamy, lipid-filled cell
present in the spleen and bone marrow
in Niemann-Pick disease. SYN: Niemann-Pick cell.
P.’s disease Niemann-Pick disease.
pickling 1. A method of preserving and
flavoring food in which the food is
soaked in a solution of salt and vinegar.
2. The use of a chemical solution to remove scales and oxides from metals after casting or before plating them.
pickwickian syndrome (pı̆k-wı̆k⬘ē-ăn)
[Inspired by Joe, an obese character in
Pickwick Papers by Charles Dickens.]
short
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1786
pico-
Obesity, decreased pulmonary function,
and polycythemia.
pico- Combining form used to indicate a
unit of measurement that is one trillionth of the basic unit.
picocurie (pı̄⬘kō-kū-rē) ABBR: pCi. An
amount of radiation equal to 10⫺12 curies. SEE: becquerel.
picogram (pı̄⬘kō-grăm) ABBR: pg. 1 ⫻
10⫺12 g or 1 trillionth of a gram.
picornavirus (pı̄-kor⬙nă-vı̄⬘rŭs) [⬙ ⫹
RNA, ribonucleic acid, ⫹ L. virus, virus] Any of a group of very small etherresistant viruses that includes enteroviruses and rhinoviruses.
picrate (pı̆k⬘răt) A salt of picric acid.
picro-, picr- [Gr. pikros, bitter] Combining forms meaning bitter.
pictograph (pı̆k⬘tō-grăf) A set of test pictures used for testing vision in children
and illiterate adults.
picture archiving and communication
system ABBR: PACS. Computers or
networks dedicated to the storage, retrieval, distribution, and presentation
of images.
PID (pı̆d) pelvic inflammatory disease.
piedra (pē-ā⬘dră) [Sp., stone] Sheathlike nodular masses in the hair of the
beard and mustache from growth of either Piedraia hortai, which causes black
piedra, or Trichosporon beigelii, which
causes white piedra. The masses surround the hairs, which become brittle;
hairs may be penetrated by fungus and
thus split. SYN: tinea nodosa. SEE: illus.
WHITE PIEDRA ON HAIR (⫻200)
pierce To penetrate body tissue, usually
in order to place an ornamental ring or
stud on the surface of the skin.
Pierre Robin syndrome (pĕ-ăr⬘rō-băn⬘)
[Pierre Robin, French physician, 1867–
1950] A congenital facial anomaly
characterized by an unusually small
jaw, cleft palate, downward displacement of the tongue, and absent gag reflex. Affected children may suffer episodes of upper airway obstruction.
piesesthesia
(pı̄-ē⬙zĕs-thē⬘zē-ă)
[Gr.
piesis, pressure, ⫹ aisthesis, sensation] Sensitivity to pressure.
piesimeter, piesometer (pı̄⬙ĕ-sı̆m⬘ĕ-tĕr,
−sŏm⬘ĕ-tĕr) [⬙ ⫹ metron, measure] A
device for measurement of the skin’s
sensitivity to pressure.
-piesis Combining form used as a suffix
meaning pressure.
pigmented
top of rh
base of rh
PIE syndrome Eosinophilic pneumonia.
piezoelectric effect (pē-ā⬘zō-ē-lĕk⬘trı̆k)
In ultrasound, a change of the mechanical action of ceramic crystals into an
electrical impulse and vice versa. SEE:
triboluminescence.
piezoelectricity
(pē-ā⬘zō-ē-lĕk-trı̆s⬙ı̆-tē)
[⬙ ⫹ elektron, amber] Production of an
electric current by application of pressure to certain crystals such as mica,
quartz, or Rochelle salt. SEE: triboluminescence.
PIF (pı̆f) proliferation inhibiting factor.
pigeon breeder’s disease (pı̆⬘jŭn) Bird
breeder’s lung.
pigeon-toed With feet turned inward.
pigment (pı̆g⬘mĕnt) [L. pigmentum,
paint] Any organic coloring matter in
the body. SEE: albino; carotene; carotenoid; words beginning with chrom-.
bile p. The waste product of the hemoglobin of old red blood cells, found in
the bile. Included are bilirubin (orange),
biliverdin (green), their derivatives
(urobilinogen, urobilin, bilicyanin, and
bilifuscin), and stercobilin, which gives
brown color to the feces. SYN: hepatogenous pigment.
blood p. A pigment in blood (hemoglobin) or a derivative of it (hematin, hemin, methemoglobin, hemosiderin).
endogenous p. A pigment produced
within the human body, as melanin.
exogenous p. A pigment produced
outside the human body.
hematogenous p. A pigment from
hemoglobin of the erythrocytes.
hepatogenous p. Bile p.
respiratory p. Any pigment such as
hemoglobin, myoglobin, or cytochrome
that has a part in the metabolism of oxygen within the body.
skin p. Melanin, melanoid, and carotene.
urinary p. Urochrome and sometimes
urobilin.
uveal p. Melanin in the choroid layer
of the eye, the ciliary processes, and the
posterior surface of the iris. Uveal pigment absorbs light within the eyeball to
prevent glare.
visual p. A light-absorbing compound in the photoreceptor cells of the
retina that converts light energy into a
nerve impulse that is passed from the
receptor cells to the optic nerve.
pigmentary (pı̆g⬘mĕn-tĕr⬙ē) [L. pigmentum, paint] Concerning, or like, a pigment.
pigmentation (pı̆g⬙mĕn-tā⬘shŭn) Coloration caused by deposition of pigments.
SEE: albinism; carotenemia; words beginning with chrom-.
hematogenous p. Pigmentation produced by the collection of hemoglobin, or
pigment carried to a site through the
blood.
pigmented (pı̆g⬘mĕnt-ĕd) Colored by a
pigment.
short
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pigmentolysin
1787
pigmentolysin (pı̆g⬙mĕn-tŏl⬘ı̆-sı̆n) [⬙ ⫹
Gr. lysis, dissolution] A substance that
destroys a pigment.
pigmentophore (pı̆g-mĕn⬘tō-for) [⬙ ⫹
Gr. phorein, to carry] A cell that carries
pigment.
pigmentum
nigrum
(pı̆g-mĕn⬘tŭm
nı̄⬘grŭm) [L., black paint] The black
pigment of the lamina vitrea of the choroid of the eye.
piitis (pı̄-ı̄⬘tı̆s) [L. pia, tender, ⫹ Gr.
itis, inflammation] Inflammation of the
pia mater.
pil L. pilula, pill, or pilulae, pills.
pil-, pilo- Combining forms meaning hair.
pila (pı̄⬘lă) pl. pilae [L., pillar] A pillarlike spicule in spongy bone.
pilar, pilary (pı̄⬘lăr, pı̆l⬘ă-rē) [L. pilaris]
Concerning, or covered with, hair.
pile [L. pila, a ball, a pillar] 1. A single
hemorrhoid. SEE: hemorrhoid. 2. The
hair. 3. A battery for production of electricity. 4. An apparatus for producing
and regulating a nuclear chain-reaction
fission process.
sentinel p. A localized thickening of
the skin at the distal end of an anal fissure.
pileous (pı̄⬘lē-ŭs) [L. pilus, hair] Hirsute.
piles (pı̄ls) [L. pila, a mass] Hemorrhoids. SEE: hemorrhoid.
pileus (pı̄⬘lē-ŭs) [L., a cap] Caul.
pili (pı̄⬘lē) sing., pilus Hairs; in bacteria,
filamentous appendages of which there
may be hundreds on a single cell. One
function of pili is to attach the bacterium to cells of the host; another is to
conjugate bacteria with each other.
p. incarnati The condition of ingrowing hair, esp. in the beard area.
p. tactiles Sensitive or tactile hairs.
p. torti A condition in which hairs
are broken and twisted.
p. trianguli et canaliculi A condition
in which the hair shaft is triangular in
cross-section and often has a groove;
seen in children with uncombable hair
syndrome. SEE: uncombable hair syndrome.
piliation (pı̄-lē-ā⬘shŭn) [L. pilus, hair]
The formation and development of hair.
piliform (pı̄⬘lı̆-form) [⬙ ⫹ forma, shape]
Hairlike.
pill (pı̆l) [L. pilula, small mass] 1. Medicine in the form of a tiny solid mass or
pellet to be swallowed or chewed; may
be coated. 2. Birth control pill.
birth control p. A class of medicines
taken orally to control conception. They
contain synthetic forms of estrogen and
progesterone or synthetic progesterone
alone. SEE: contraceptive.
morning-after p. A pill containing
estrogen, progesterone, or both that
must be taken within 72 hr after intercourse to prevent pregnancy.
pillar (pı̆l⬘ĕr) [L. pila, a column] An up-
pilonidal
right support, column, or structure resembling a column.
p. cell One of two groups of cells (inner and outer) resting on the basement
membrane of the organ of Corti in which
elongated bodies (pillars) develop.
These enclose the inner tunnel (Corti’s
tunnel).
p. of the fauces Folds of mucous
membrane, one on each side of the fauces and between which is situated the
palatine tonsil. The anterior pillar (in
front of the tonsil) is also called the glossopalatine arch; the posterior pillar (behind the tonsil) is also called the pharyngopalatine arch.
pillion (pı̆l⬘yŭn) [L. pellis, skin] A
temporary form of artificial leg, esp. a
peg-leg type of stump.
pillow A postsurgical cushion or support
for a body part (e.g., the head, chest, hip,
or knee). Therapeutic pillows are used
as buttresses or wedges to relieve stress
on parts of the body that have been operated on. Chest pillows are used after
sternotomy to support the chest wall
and limit pain from deep breathing or
coughing. Pillows placed under or between the lower extremities are often
used to maintain neutral or desired
alignment of joints after joint replacement surgeries.
abductor p. A pillow or cushioned
wedge placed between the legs of a patient after total hip replacement to
maintain proper positioning and prevent dislocation/abduction of the joint.
pilo- [L. pilus] Combining form indicating hair.
pilobezoar (pı̄⬙lō-bē⬘zor) [⬙ ⫹ Arabic
bazahr, protecting against poison] Trichobezoar.
pilocarpine iontophoresis A test used to
diagnose cystic fibrosis in which sweat
glands on the skin are stimulated by an
electrode after the skin has been wetted
with pilocarpine. Elevated levels of chloride in the sweat establish the diagnosis. SYN: sweat test.
pilocystic (pı̄⬙lō-sı̆s⬘tı̆k) [L. pilus, hair,
⫹ Gr. kystis, bladder] Encysted and
containing hair, said of a dermoid cyst.
piloerection (pı̄-lō-ē-rĕk⬘shŭn) Elevation of the hair above the skin as a result of contraction of the arrector pili
muscles. This may occur after exposure
to the cold or during adrenergic stimulation. SYN: cutis anserina; goose flesh;
horripilation.
pilojection (pı̄-lō-jĕk⬘shŭn) [⬙ ⫹ jacere,
to throw] Introduction of hairs, by use
of a pneumatic gun, into an aneurysm
to induce clotting in the aneurysmal sac.
It has been used in treating intracranial
aneurysms.
pilomotor (pı̄⬙lō-mō⬘tor) [⬙ ⫹ motor,
mover] Causing movements of hairs, as
the arrectores pilorum.
pilonidal (pı̄⬙lō-nı̄⬘dăl) [⬙ ⫹ nidus, nest]
top of rh
base of rh
short
standard
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pilosebaceous
pinkeye
top of rh
base of rh
cells with a polyhedral shape and deposits of cementum. It is often associated with an impacted tooth. SYN: calcifying epithelial odontogenic tumor.
pineal
(pı̆n⬘ē-ăl)
[Fr., pine cone]
1. Shaped like a pine cone. 2. Pert. to
the pineal gland.
pineal body SEE: pineal gland.
pinealectomy (pı̆n⬙ē-ăl-ĕk⬘tō-mē) [L. pineus, of the pine, ⫹ Gr. ektome, excision] Removal of the pineal gland.
pinealoblastoma (pı̆n⬙ē-ă-lō-blăs-tō⬘mă)
[⬙ ⫹ Gr. blastos, germ, ⫹ oma, tumor] Pineoblastoma.
pinealocyte (pı̆n⬘ē-ă-lō-sı̄t⬙) [⬙ ⫹ Gr.
kytos, cell] The principal cell of the pineal gland. It contains pale-staining cytoplasm and has long processes that terminate in bulbous expansions.
pinealoma (pı̆n⬙ē-ă-lō⬘mă) [⬙ ⫹ Gr.
oma, tumor] A tumor of the pineal
gland, usually encapsulated; often associated with precocious puberty.
pinealopathy (pı̆n⬙ē-ă-lŏp⬘ă-thē) [⬙ ⫹
Gr. pathos, disease, suffering] Any disorder of the pineal gland.
Pinel, Philippe (pē-nĕl⬘) French psychologist, 1745– 1826, who developed a
method or system of treating the mentally ill without the use of restraint, at
a time when use of restraint was the accepted form of therapy.
pineoblastoma (pı̆n⬙ē-ō-blăs-tō⬘mă) [L.
pineus, of the pine, ⫹ Gr. blastos,
germ, ⫹ oma, tumor] A malignant tumor of the pineal gland that may occur
in childhood and early adulthood. SYN:
pinealoblastoma.
pineocytoma (pı̆n-ē-ō-sı̄-tō⬘mă) A malignant tumor of the pineal gland of the
brain.
ping-ponging (pı̆ng-pŏng-ēng) [Ping
Pong, trademark for table tennis] The
transmission of an infectious disease,
esp. a sexually transmitted one, between two people. After the first person
has been cured, the second person reinfects the first.
pinguecula (pı̆n-gwĕk⬘ū-lă) [L. pinguiculus, fatty] A yellow triangular thickening of the bulbar conjunctiva on the
inner and outer margins of the cornea.
The base of the triangle is toward the
limbus. The yellow color is due to an increase in elastic fibers.
pinhole (pı̆n⬘hōl) [AS. pinn, pin, ⫹ hol,
hole] A small perforation made by, or
the size of that made by, a pin.
p. os A very small opening to the
uterus from the vagina. It may be
present in very young women.
pinhole meatus Stricture of the urethra.
piniform (pı̆n⬘ı̆-form) [L. pinea, pine
cone, ⫹ forma, shape] Conical;
shaped like a pine cone.
pink disease Acrodynia.
pinkeye [D. pinck oog] Inflammation of
the conjunctiva, usually characterized
by redness, watery discharge, lid edema,
short
standard
1788
Containing hairs; most often seen in a
dermoid cyst, esp. in the saccrococcygeal
region.
pilosebaceous (pı̄⬙lō-sē-bā⬘shŭs) [⬙ ⫹
sebaceus, fatty] Concerning the hair
and sebaceous glands.
pilus (pı̄⬘lŭs) pl. pili [L.] A hair.
p. cuniculatus A hair that burrows
into the skin.
p. incarnatus An ingrown hair.
p. tortus A twisted hair.
PImax maximum inspiratory pressure.
SEE: force, maximum inspiratory.
pimel-, pimelo [Gr. pimele, fat] Combining form meaning fat or fatty.
pimelopterygium (pı̆m⬙ĕ-lō-tĕ-rı̆j⬘ē-ŭm)
[⬙ ⫹ pterygion, wing] A fatty outgrowth of the conjunctiva.
pimelosis (pı̆m⬙ĕ-lō⬘sı̆s) [⬙ ⫹ osis, condition] 1. Conversion into fat. 2. Fatty
degeneration of any tissue. 3. Obesity.
pimple (pı̆m⬘pl) [ME. pinple] A papule
or pustule of the skin often seen in clusters on skin of the adolescent with acne.
pin A short, slim piece of wire, plastic, or
metal. It may have one end blunt and
the other sharp.
endodontic p. A straight or threaded
filling that is passed through the root
canal to the alveolar bone beyond the
apex of the tooth root.
self-threading p. A pin screwed
through a small hole into dentin.
sprue p. In dentistry, a wax, plastic,
or metal pattern used to make the channel or channels through which molten
metal flows into a mold to make a casting. Also called sprue former.
pincement (păns-mŏn⬘) [Fr.] Pinching
or nipping of the flesh in massage.
pinch A type of hand prehension. The
pinch of the human hand is achieved
principally through holding objects between the thumb and index finger or the
index and long fingers.
Hand pinch is classified according to
the anatomical parts involved, as follows:
Pinch, fingertip— pinch using the tips
of strongly arched digits, primarily the
thumb and index finger; used to pick up
very small objects such as pins and needles.
Pinch, palmar tripod or three-jaw
chuck— pinch using the palmar pads of
the thumb and index and long fingers.
Pinch, lateral— pinch accomplished
by clamping the palmar surface of the
distal portion of the thumb against the
side of the index finger.
pinched nerve A colloquial term for nerve
entrapment syndrome.
pinch meter A device for objectively measuring the strength of hand pinch in
grams or pounds.
Pindborg tumor (pı̆nd⬘bawrg⬙) [20th
century physician; first described in the
1950s] A rare tumor, typically of the
jaw, consisting of malignant epithelial
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1789
pinna
itching, and a gritty sensation. Most
commonly caused by a contagious viral
infection. Depending on the cause,
pinkeye may be treated conservatively
(e.g., with warm, moist compresses) or
with antibiotics when bacteria are the
cause.
pinna (pı̆n⬘ă) pl. pinnae [L., feather]
1. The auricle or projected part of the
external ear. It directs sound waves into
the external acoustic meatus toward the
tympanic membrane. 2. A feather, fin,
wing, or similar appendage.
pinocyte (pı̄⬘nō-sı̄t) [Gr. pinein, to drink,
⫹ kytos, cell] A cell that exhibits pinocytosis.
pinocytosis (pı̄⬙nō-sı̄-tō⬘sı̆s) [⬙ ⫹ ⬙ ⫹
osis, condition] The process by which
cells absorb or ingest nutrients and
fluid. An invaginating portion of the cell
membrane encircles the nutrient, enclosing it in a membrane-bound sac. The
sac is brought into the cell and its contents are digested. SEE: illus.
pinosome (pı̄⬘nō-, pı̆n⬘ō-sōm) [⬙ ⫹
soma, body] The fluid-filled vacuole
formed during pinocytosis.
pinprick test A test for cutaneous pain receptors. A small, clean, sharp object
such as a pin or needle is gently applied
to the skin and the patient is asked to
describe the sensation. One must be certain the patient is reporting the sensation of pain rather than that of pressure.
Usually, application of the sharp object
is interspersed with application of a dull
object, and the patient is asked to state
each time whether a sharp or dull sen-
FUSION
FUSION
pioepithelium
top of rh
base of rh
sation was felt. The patient is not, of
course, allowed to observe the test procedure.
The sharp object should not penetrate the dermis, and to prevent
passage of infectious material from one
patient to another, the test objects should
be either discarded after use or sterilized
before their use on another patient.
PINS (pı̆nz) persons in need of supervision.
Pins’ sign (pı̆nz) [Emil Pins, Aust. physician, 1845– 1913] In pericarditis, disappearance of symptoms of pleurisy
when the patient assumes knee-chest
position.
pint (pı̄nt) [ME. pinte] ABBR: pt. In the
U.S. a measure of capacity equal to 1⁄2
qt.; 16 fl. oz; 473.2 ml. SEE: Weights and
Measures Appendix.
pinta (pēn⬘tă) [Sp., paint] A nonvenereal disease spread by body contact,
caused by the spirochete Treponema
carateum. It is manifested by depigmented spots or patches. The treatment
is administration of penicillin.
pintid (pı̆n⬘tı̆d) A flat red skin lesion
present in the second stage of pinta.
pinworm (pı̆n⬘wŭrm⬙) Any of numerous
long, slender nematode worms, esp. of
the genus Enterobius. They parasitize
humans. SEE: Enterobius vermicularis.
pioepithelium (pı̄⬙ō-ĕp⬙ı̆-thē⬘lē-ŭm) [Gr.
pion, fat, ⫹ epi, upon, ⫹ thele, nip-
SEPARATION
SEPARATION
PINOCYTOSIS AND EXOCYTOSIS
(Top) Pinocytosis; (Bottom) Exocytosis
STABILIZATION
STABILIZATION
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
pioglitazone
pitting
top of rh
base of rh
grooves. It contributes to pit and fissure
caries. SYN: occlusal p.
anal p. Proctodeum.
gastric p. One of many minute depressions (foveolae) in the gastric mucosa into which the gastric glands open.
nasal p. In the embryo, one of two
horseshoe-shaped depressions on the
ventrolateral surface of the head
bounded by lateral and median nasal
processes. It gives rise to nostrils and a
portion of the nasal fossa. SYN: olfactory pit.
occlusal p. Pit (3).
olfactory p. Nasal p.
primitive p. A minute depression at
the anterior end of the primitive groove
or streak and immediately posterior to
the primitive knot.
p. of the stomach 1. Colloquial term
for the depression at the end of the xiphoid process. 2. Colloquial term for
the center of the abdominal region
above the navel.
pitch (pı̆ch) [ME. picchen, to fix] 1. That
quality of the sensation of sound that
enables one to classify it in a scale from
high to low. It is dependent principally
on frequency of vibrations. 2. Residue
obtained from distillation of coal or
wood tar. 3. In radiography, the table
speed divided by the width of the x-ray
beam.
pitchblende (pı̆ch⬘blĕnd) Uraninite, the
principal source of uranium. It is a mineral that resembles pitch.
pith (pı̆th) 1. The center of a hair or the
soft material in the stalk of a plant.
2. Destruction of a part of the central
nervous system of an animal being prepared for certain experiments. A blunt
probe is inserted in the brain or spinal
cord through a foramen.
pithing (pı̆th⬘ı̆ng) [ME. pithe] Destruction of the central nervous system by
the piercing of brain or spinal cord, as
in vivisection. This is done on experimental animals to render them insensible to pain and to inhibit controlling
effects of the central nervous system
during research and experimentation.
SEE: decerebration.
pithode (pı̄⬘thōd) [Gr. pithose, wine cask,
⫹ eidos, form, shape] The barrelshaped spindle formed during karyokinesis.
Pitres’ section (pē-trēs⬘) [Jean A. Pitres,
Fr. physician, 1848– 1927] Any of the
series of six coronal vertical sections of
the brain for study. The sections are
prefrontal, pediculofrontal, frontal, parietal, pediculoparietal, and occipital.
pitting (pı̆t⬘ı̆ng) [ME. pitt, hole] 1. The
formation of pits, depressions, or scars,
as in smallpox. 2. In the spleen, removal
of the remains of red blood cells that
have completed their lifespan or have
been injured. Nucleated red blood cells
are also removed from circulating blood
short
standard
1790
ple] Epithelium that contains fat globules.
pioglitazone (pı̄⬙ ō-glı̆t⬘ ŭ-zōn⬙) A thiazolidinedione administered orally as an
adjunct to diet and exercise for the management of type 2 diabetes mellitus. Its
therapeutic class is antidiabetic (oral).
pion therapy (pı̄⬘ŏn) The use of subatomic particles, called pions, to treat
brain cancers and some sarcomas.
PIP peak inspiratory pressure; proximal
interphalangeal (joint)
Piper (pı̄⬘pĕr) [L.] Genus of plants that
produce pepper.
Piper forceps (pı̄p⬘ ĕr) Forceps designed
to deliver the infant’s head during a
breech delivery, after other maneuvers
to deliver the head have failed.
pipet, pipette (pı̄-pĕt⬘) [Fr. pipette, tiny
pipe] Narrow glass tube with both ends
open for transferring and measuring liquids by suctioning them into the tube.
piriform, pyriform (pı̆r⬘ı̆-form) [L. pirum, pear, ⫹ forma, shape] Pearshaped.
piriformis syndrome (pı̆r-ē-fŏr⬘mı̆s) A
condition marked by pain in the hip and
buttock that radiates up into the lower
back and down the leg. In women, the
pain may occur during sexual intercourse. This is caused by entrapment of
the sciatic nerve as it passes through
the piriformis muscle in the buttock. Because the symptoms mimic those caused
by a herniated lumbar disk, the syndrome may be confused with that disease. Treatment includes physical therapy to relieve pressure, ultrasound to
reduce muscle spasm, and anti-inflammatory medicines. Surgical therapy to
free the entrapped nerve may be necessary. SEE: sciatica.
Pirogoff’s amputation (pı̆r⬙ō-gŏfs⬘) [Nikolai Ivanovich Pirogoff, Russ. surgeon,
1810– 1881] Foot amputation at the
ankle, removing a portion of the os calcis.
piroplasm (pı̄⬘rō-plăzm) A sporozoan
protozoan of the subclass Piroplasia,
such as the genus Babesia.
Pirquet’s test (pĕr-kāz⬘) [Clemens Peter
Johann von Pirquet, Austrian pediatrician, 1874– 1929] A test for tuberculosis by means of a skin reaction, used
esp. in children.
pisiform (pı̄⬘sı̆-form) [L. pisum, pea, ⫹
forma, shape] 1. Pea-shaped. 2. The
smallest carpal bone, located in the
flexor carpi ulnaris tendon as a sesamoid bone, on the ulnar side in the proximal row of carpals.
pit (pı̆t) [ME. pitt, hole] 1. A tiny hollow
or pocket. SYN: depression; fossa. 2. To
be or become marked with a shallow depression; to cause a depression on pressure in edema. 3. A small depression in
the enamel surface of a tooth often connected with one or more developmental
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pituicyte
1791
in this pitting function. SEE: culling.
3. In dentistry, the formation of depressions in the materials used in restoring
teeth. 4. In radiography, the imperfections created on the face of the x-ray
tube anode by overloading current limits.
pituicyte (pı̆-tū⬘ı̆-sı̄t) [L. pituita, phlegm,
⫹ Gr. kytos, cell] A modified branched
neuroglia cell characteristic of pars
nervosa of the posterior lobe of the pituitary gland; also present in the infundibular stalk.
pituitary (pı̆-tū⬘ı̆-tār⬙ē) [L. pituitarius,
phlegm] The pituitary body or gland.
SYN: hypophysis. SEE: releasing hormone; inhibitory hormone; pituitary
gland.
anterior p. A preparation consisting
of dried, defatted, powdered anterior
lobe of the pituitary gland of domestic
animals.
posterior p. The dried, powdered
posterior lobe of the pituitary gland of
animals used as food by humans.
pituitary (injection), posterior Antidiuretic hormone.
pituitary body Obsolete term for the pituitary gland.
pituitary gland A small, gray, rounded
gland that develops from ingrown oral
epithelium (Rathke’s pouch) and is attached to the lower surface of the hypothalamus by the infundibular stalk.
The Rathke’s pouch portion forms the
anterior lobe and an intermediate area;
the neural tissue of the infundibular
stalk forms the posterior lobe. The pituitary gland averages 1.3 ⫻ 1.0 ⫻0.5
cm in size and weighs 0.55 to 0.6 g. SYN:
hypophysis cerebri. SEE: illus. (Pituitary Gland and Hypothalamus).
FUNCTION: The pituitary is an endocrine gland secreting a number of hormones that regulate many bodily processes including growth, reproduction,
and other metabolic activities. It is often
referred to as the “master gland of the
body.” SEE: illus. (Pituitary Hormones
and Target Organs).
Hormones are secreted in the following lobes: Intermediate lobe: In coldblooded animals, intermedin is secreted, influencing the activity of
pigment cells (chromatophores) of
fishes, amphibians, and reptiles. In
warm-blooded animals, no effects are
known.
Anterior lobe: Secretions here are the
somatotropic, or growth hormone (STH
or GH), which regulates cell division
and protein synthesis for growth; adrenocorticotropic hormone (ACTH), which
regulates functional activity of the adrenal cortex; thyrotropic hormone (TTH
or TSH), which regulates functional activity of the thyroid gland; and prolactin, also called lactogenic hormone,
which induces secretion of milk in the
pityriasis
top of rh
base of rh
adult female. The gonadotropic hormones are as follows: in women, folliclestimulating hormone (FSH) stimulates
development of ovarian follicles and
their secretion of estrogen; in men, it
stimulates spermatogenesis in the testes. In women, luteinizing hormone
(LH) stimulates ovulation and formation of the corpus luteum and its secretion of estrogen and progesterone. In
men LH, also called interstitial cellstimulation hormone (ICSH), stimulates testosterone secretion.
Posterior lobe: Hormones are secreted
by the neurosecretory cells of the hypothalamus and pass through fibers of the
supraopticohypophyseal tracts in the
infundibular stalk to the neurohypophysis, where they are stored. Secretions here are oxytocin, which acts specifically on smooth muscle of the uterus,
increasing tone and contractility, and
antidiuretic hormone (ADH), which increases reabsorption of water by the
kidney tubules. In large amounts ADH
also causes vasoconstriction, and is also
called vasopressin.
DISORDERS: Hypersecretion of anterior lobe causes gigantism, acromegaly,
and pituitary basophilism (Cushing’s
disease). Hyposecretion of anterior lobe
causes dwarfism, pituitary cachexia
(Simmonds’ disease), Sheehan’s syndrome, acromicria, eunuchoidism, or
hypogonadism. Posterior lobe deficiency
or hypothalamic lesion causes diabetes
insipidus. Anterior and posterior lobe
deficiency and hypothalamic lesion
cause Fröhlich’s syndrome (adiposogenital dystrophy) and pituitary obesity.
pityriasis (pı̆t⬙ı̆-rı̄⬘ă-sı̆s) [Gr. pityron,
bran, ⫹ −iasis, disease] A skin disease
characterized by branny scales.
p. alba A form of decreased melanin
in the skin marked by patches of round
or oval macular skin lesions with fine
adherent scales. The lesions are commonly seen in the facial areas of children. They are virtually painless and
usually require no therapy. They may
disappear spontaneously. The etiology
is unknown, but the disease is regarded
as a mild form of eczema.
p. capitis Dandruff.
p. lichenoides et varioliformis, acuta
ABBR: PLEVA. A skin disorder characterized by development of an edematous pink papule that undergoes central
vesiculation and hemorrhagic necrosis.
The lesions clear spontaneously after
weeks or months but leave scars.
p. linguae Transitory benign
plaques of the tongue. SYN: geographic
tongue.
p. nigra Tinea nigra.
p. rosea An acute inflammatory skin
disease of unknown etiology, marked by
a macular eruption on the trunk,
obliquely to the ribs, and on the upper
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
1792
pityriasis
placebo
top of rh
base of rh
HYPOTHALAMUS
HYPOTHALAMIC-HYPOPHYSEAL TRACT
OPTIC CHIASMA
POSTERIOR PITUITARY
INFERIOR HYPOPHYSEAL ARTERY
HORMONES OF POSTERIOR PITUITARY
POSTERIOR LOBE VEIN
A
HYPOTHALAMUS
RELEASING HORMONES
OPTIC CHIASMA
CAPILLARIES IN HYPOTHALAMUS
HYPOPHYSEAL
PORTAL VEINS
SUPERIOR HYPOPHYSEAL
ARTERIES
CAPILLARIES IN ANTERIOR PITUITARY
HORMONES OF ANTERIOR PITUITARY
LATERAL HYPOPHYSEAL VEIN
B
PITUITARY GLAND AND HYPOTHALAMUS
(A) posterior, (B) anterior
extremities. The initial (herald) patch
appears in more than half of the cases.
In a few days it enlarges to several centimeters. Then, within 2 to 21 days, secondary eruptions occur. They are rosered and somewhat scaly with a clearing
in the center, or reddish ring-shaped
patches symmetrically distributed over
the limbs. The symptoms disappear
spontaneously within 2 to 10 weeks.
Treatment consists of the local application of antipruritics.
p. rubra pilaris Persistent general
exfoliative dermatitis of unknown etiology. SEE: exfoliative dermatitis.
p. versicolor Tinea versicolor.
Pityrosporum (pı̆⬙tı̆-rō-spawr⬘ŭm, −rŏs⬘pŭrŭm) SEE: Malasesezia.
pivot (pı̆v⬘ŭt) In dentistry, a part used
for attaching an artificial crown to the
base of a natural tooth.
pixel pı̆k⬘sı̆l, −sĕlA picture element, i.e.,
an individually adjustable picture element in a digital image. Variations in
its size and brightness contribute to the
resolution and contrast of the image.
PJC premature junctional contraction.
PK psychokinesis.
pK Abbreviation for the negative logarithm of the ionization constant, called
K, of an acid. The closer the pK to the
pH, the greater the buffering power of
the system.
PKU phenylketonuria.
placebo (plă-sē⬘bō) [L. placebo, I shall
please] 1. An inactive substance or
short
standard
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1793
placement
placenta
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HYPOTHALAMUS
POSTERIOR PITUITARY
ANTERIOR PITUITARY
KIDNEYS
ADH
BONES, ORGANS
GH
OX
YT
OC
IN
TH
AC
O
PR
IN
CT
LA
TS
H
UTERUS
FSH
LH
ADRENAL
CORTEX
BREASTS
THYROID
OVARIES
TESTES
ANTERIOR PITUITARY HORMONES
POSTERIOR PITUITARY HORMONES
PITUITARY GLAND
Pituitary hormones and target organs
treatment given instead of one that has
a proven effect. 2. A drug or treatment
used as a nonspecific or inactive control
in a test of a therapy that is suspected
of being useful for a particular disease
or condition. The placebo is given to one
group of patients, and the drug being
tested is given to a similar group; then
the results obtained in the two groups
are compared. Placebos often elicit a response, possibly because of patient expectations that they will produce a cure
or prove harmful.
ETHICS: Placebos are not legitimate
treatments and should be prescribed
and administered only under tightly
controlled conditions as part of a clinical
trial approved by an institutional review board (IRB). Placebos should not
be used without the informed consent of
the patient, i.e., an explicit understanding that a patient in a trial may receive
an inactive agent. When clinical use of
a placebo involves deceiving the patient,
such use is unethical. Deception of a patient constitutes a failure to respect
his rights to make informed decisions
and undermines the element of trust
that is crucial to every interaction between patient and caregiver.
placement (plās⬘mı̆nt) 1. The positioning or implantation of a object, such as
a catheter or stent, within or near a
body part. 2. The assignment of a patient to a particular care facility, treatment program, or level of care. 3. The
assignment of a student in a health profession to a specialized learning environment, such as a clinic, hospital, or
ward, where he or she performs professional activities under supervision.
placenta (plă-sĕn⬘tă ) pl. placentae pl.
placentas [L., a flat cake] The oval or
discoid spongy structure in the uterus of
eutherian mammals from which the fetus derives its nourishment and oxygen.
SEE: illus. placental, adj.
ANATOMY: The placenta consists of a
short
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1794
placenta
placenta
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MATERNAL BLOOD
SINUS
CHORIONIC
VILLUS
MATERNAL
ARTERIOLE
MATERNAL
VENULE
FETAL ARTERIOLE
AND VENULE
UMBILICAL CORD
UMBILICAL VEIN
MYOMETRIUM
(MATERNAL
PART OF
PLACENTA)
UMBILICAL ARTERIES
CHORION
(FETAL PART OF
PLACENTA)
PLACENTA
Maternal and fetal portions
fetal portion, the chorion frondosum,
bearing many chorionic villi that interlock with the decidua basalis of the
uterus, which constitutes the maternal
portion. The chorionic villi lie in spaces
in the uterine endometrium, where they
are bathed in maternal blood and
lymph. Groups of villi are separated by
placental septa forming about 20 distinct lobules called cotyledons.
Attached to the margin of the placenta is a membrane that encloses the
embryo. It is a composite of several
structures (decidua parietalis, decidua
capsularis, chorion laeve, and amnion).
At the center of the concave side is attached the umbilical cord through
which the umbilical vessels (two arteries and one vein) pass to the fetus.
The cord is approx. 50 cm (20 in.) long
at full term.
The mature placenta is 15 to 18 cm (6
to 7 in.) in diameter and weighs about
450 gm (approx. 1 lb). When expelled
following parturition, it is known as the
afterbirth.
Maternal blood enters the intervillous spaces of the placenta through spiral arteries, branches of the uterine arteries. It bathes the chorionic villi and
flows peripherally to the marginal sinus, which leads to uterine veins. Food
molecules, oxygen, and antibodies pass
into fetal blood of the villi; metabolic
waste products pass from fetal blood
into the mother’s blood. Normally, there
is no admixture of fetal and maternal
blood. The placenta is also an endocrine
organ. It produces chorionic gonadotropins, the presence of which in urine is
the basis of one type of pregnancy test.
Estrogen and progesterone are also secreted by the placenta.
abruption of p. Abruptio placentae.
accessory p. A placenta separate
from the main placenta.
p. accreta A placenta in which the
cotyledons have invaded the uterine
musculature, resulting in difficult or impossible separation of the placenta.
adherent p. A placenta that remains
adherent to the uterine wall after the
normal period following childbirth.
annular p. A placenta that extends
like a belt around the interior of the
uterus. SYN: zonary placenta.
battledore p. A form of insertion of
the umbilical cord into the margin of the
placenta in which it spreads out to resemble a paddle or badminton racket.
bidiscoidal p. A placenta with two
separate portions attached to separate
sites on the wall of the uterus, occasionally found in humans.
bilobate p. A placenta consisting of
two lobes. SYN: dimidiate placenta.
bipartite p. A placenta divided into
two separate parts.
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placenta
1795
chorioallantoic p. A placenta in which
the allantoic mesoderm and vessels fuse
with the inner face of the serosa to form
the chorion.
circinate p. A cup-shaped placenta.
p. circumvallata A placenta whose
membranes wrap over the edge of the
fetal surface of the organ.
circumvallate p. Placenta circumvallata.
cirsoid p. A placenta with appearance
of varicose veins.
cordiform p. A placenta having a
marginal indentation, giving it a heart
shape.
deciduate p. A placenta of which the
maternal part escapes with delivery.
dimidiate p. Bilobate p.
discoid p. A placenta that constitutes
practically one circumscribed and circular mass.
double p. A placental mass of the two
placentae of a twin gestation.
endotheliochorial p. A placenta in
which the syncytial trophoblasts of the
chorion penetrate to the blood vessels of
the uterus.
epitheliochorial p. A placenta in
which the chorion is next to the lining of
the uterus but does not invade or erode
the lining.
p. fenestrata A placenta in which a
portion of the placental tissue is thinning or absent.
fetal p. That part of the placenta
formed by aggregation of chorionic villi
in which the umbilical vein and arteries
ramify.
fundal p. A placenta attached to the
uterine wall within the fundal zone.
hemochorial p. A placenta in which
the maternal blood is in direct contact
with the chorion. The human placenta
is of this type.
hemoendothelial p. A placenta in
which the maternal blood is in contact
with the endothelium of the chorionic
vessels.
horseshoe p. A formation in which
the two placentae of a twin gestation are
united.
incarcerated p. A placenta retained in
the uterus by irregular uterine contractions after delivery.
p. increta A form of placenta accreta
in which the chorionic villi invade the
myometrium.
lateral p. A placenta attached to the
lateral wall of the uterus.
maternal p. A portion of the placenta
that develops from the decidua basalis
of the uterus.
membranous p. Thinning of the placenta from atrophy.
multilobate p. A placenta with more
than three lobes.
nondeciduate p. A placenta that does
not shed the maternal portion.
p. percreta A type of placenta ac-
placenta
creta in which the myometrium is invaded to the serosa of the peritoneum
covering the uterus. This may cause
rupture of the uterus.
p. previa ABBR: PP. A placenta
that is implanted in the lower uterine
segment. There are three types: centralis, lateralis, and marginalis. Placenta previa centralis (total or complete
PP) is the condition in which the placenta has been implanted in the lower
uterine segment and has grown to completely cover the internal cervical os.
Placenta previa lateralis (low marginal
implantation) is the condition in which
the placenta lies just within the lower
uterine segment. Placenta previa marginalis is the condition in which the placenta partially covers the internal cervical os (partial or incomplete PP). SEE:
Nursing Diagnoses Appendix.
SYMPTOMS: The condition is more
common in multigravidas than primigravidas, and occurs in about 1 in every
200 pregnancies. Slight hemorrhage, recurrent with greater severity, appears
in the seventh or eighth month of pregnancy. Gradual anemia, pallor, rapid
weak pulse, air hunger, and low blood
pressure occur.
DIAGNOSIS: Painless bleeding during the last 3 months and a placenta
found in the lower portion of the uterus
are diagnostic.
TREATMENT: The blood supply before and during delivery should be conserved. Postpartum hemorrhage should
be prevented or controlled. Anemia
should be treated before and after labor.
Prevention of sepsis is necessary.
PROGNOSIS: The prognosis for the
mother is good with control of hemorrhage and prevention of sepsis. Prognosis for the fetus depends on gestational age and the amount of blood lost,
but continuous monitoring and rapid intervention help to prevent neonatal
death.
PATIENT CARE: In a calm environment, the patient is told what is happening; then the procedure of vaginal
ultrasound is explained. The patient is
told that if the ultrasound examination
reveals a placenta previa, sterile vaginal examination will be delayed if possible until after 34 weeks’ (preferably 36
weeks’) gestation (to enhance the
chances for fetal survival) and then will
be carried out only as a “double-setup”
procedure, with all preparations needed
for immediate vaginal or cesarean delivery. (If, however, the ultrasound examination reveals a normally implanted
placenta, a sterile vaginal speculum examination is performed to rule out local
bleeding causes, and a laboratory study
is ordered to rule out coagulation problems.)
The patient is maintained on absolute
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placenta
placode
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maternal anxiety helps reduce uterine
irritability, so a mental health practitioner should be consulted if the patient
does not respond to nursing interventions (e.g., relaxation techniques,
guided imagery) or if the patient’s previous coping skills are known to be ineffective.
p. previa partialis A placenta that
only partially covers the internal os of
the uterus.
p. reflexa An abnormal placenta in
which the margin is thickened and appears to turn back on itself.
reniform p. A kidney-shaped placenta.
retained p. A placenta not expelled
within 30 min after completion of the
second stage of labor.
p. spuria An outlying portion of the
placenta that has not maintained its
vascular connection with the decidua
vera.
succenturiate p. An accessory placenta that has a vascular connection to
the main part of the placenta.
trilobate p. A placenta with three
lobes.
tripartite p. A three-lobed placenta attached to a single fetus.
triple p. A placental mass of three
lobes in a triple gestation.
p. uterina The maternal part of the
placenta.
velamentous p. A placenta with the
umbilical cord attached to the membrane a short distance from the placenta, the vessels entering the placenta
at its margin.
villous p. A placenta in which the chorion forms villi.
zonary p. Annular p.
placental (plă-sĕn⬘tăl) [L. placenta, a flat
cake] Rel. to the placenta.
p. blood banking The use of human
placental tissue as a source of fetal
blood and hematopoietic stem cells.
placentation (plă⬙sĕn-tā⬘shŭn) The process of formation and attachment of the
placenta.
placentitis (plă⬙sĕn-tı̄⬘tı̆s) [⬙ ⫹ Gr. itis,
inflammation] Inflammation of the placenta.
placentography (plă⬙sĕn-tŏg⬘ră-fē) [⬙ ⫹
Gr. graphein, to write] Examination of
the placenta by radiography.
indirect p. Measurement of the space
between the placenta and the head of
the fetus by means of radiographical examination. It is done to diagnose placenta previa.
Placido’s disk (plă-sē⬘dōz) [Antonio Placido,
Portuguese
ophthalmologist,
1848– 1916] A disk marked with concentric black and white circles used in
determining the amount and character
of corneal irregularity.
placode (plăk⬘ōd) [Gr. plax, plate, ⫹ eidos, form, shape] In embryology, a
short
standard
1796
bedrest and under close supervision
(usually in the hospital) to extend the
period of gestation until 36 weeks, when
fetal lung maturity is likely (or can be
stimulated to mature 48 hr before delivery). Intravenous access is established
using a large-bore catheter, and continuous external electrode fetal monitoring
is initiated. Maternal vital signs are
closely monitored, and the amount of
vaginal bleeding is assessed. The laboratory types and cross-matches blood
for emergency use; the number of units
is based on the assessment of the particular patient’s possible requirements.
The patient’s hematocrit level is kept at
30% or greater. The patient is prepared
physically and emotionally for cesarean
delivery; vaginal delivery may be attempted, but only if the previa is marginal, bleeding is minimal, and labor is
rapidly progressing.
After delivery, the patient is monitored closely for continued bleeding,
which may occur from the large vascular channels in the lower uterine segment, even if the fundus is firmly contracted. Prophylactic antibiotic therapy
may be prescribed because of the patient’s propensity for infection. Oxytocic
drugs are given to control bleeding;
packed cells or whole blood also are
given. The obstetrical surgery team remains available, in case further intervention is required. The patient’s hemodynamic
status
is
monitored
continuously, to provide blood and fluid
replacement needed to prevent and
treat hypovolemia while avoiding hypervolemia.
Although maternal mortality remains
a concern, the patient and her family
should be assured that this is unlikely
but not impossible in most large treatment centers because of the conservative regimen that is followed. A pediatric team is present at delivery to assess
and treat neonatal hypoxia, anemia,
blood loss, and shock. In the event of fetal distress or death, the family is informed that these are related to detachment of a significant portion of the
placenta or to maternal hypovolemic
shock, or both. All parents are provided
opportunities to be with and touch their
(usually premature) neonate in the critical care nursery. In cases of fetal demise, the infant is carefully wrapped
and the parents encouraged to hold
their baby, and to examine it as they desire. Infant photographs may be taken
to provide memories for the family. The
patient and family require the health
care providers’ empathetic concern and
support. A social service consultation is
set up if financial or home and family
care concerns require agency referrals;
spiritual counseling is supplied according to the patient’s wishes. Reducing
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
placode
1797
platelike thickening of epithelium, usually the ectoderm, that serves as the
precursor of an organ or structure.
auditory p. A dorsolateral placode located alongside the hindbrain that gives
rise to the otocyst, which in turn develops into the internal ear.
lens p. A placode developing in the
ectoderm directly overlying the optic
vesicle. It forms the lens vesicle, which
becomes enclosed in the optic cup and
eventually becomes the lens of the eye.
olfactory p. A placode that first gives
rise to the olfactory pit and later to the
major portion of the nasal cavity.
placoid (plăk⬘oyd) [⬙ ⫹ eidos, form,
shape] Platelike.
plagio- [Gr. plagios, slanting or sideways] Combining form meaning slanting, oblique.
plagiocephaly (plā⬙jē-ō-sĕf⬘ă-lē) A malformation of the skull producing the appearance of a twisted and lopsided head;
caused by irregular closure of the
cranial sutures.
plague (plāg) [L., plaga, blow, injury]
1. Any widespread contagious disease
associated with a high death rate. 2. An
often fatal disease caused by Yersinia
pestis. The natural hosts are ground
squirrels, wild rodents, and rats; the
vector is the rat flea. In the U.S., hunters, trappers, and campers may encounter infected mammals. Outbreaks are
also associated with crowded living conditions and poor sanitation. Although
plague was responsible for millions of
deaths during the Middle Ages, improvements in sanitation, medical care,
and the availability of antibiotics now
prevent widespread epidemics. Plague
is characterized by high fever, restlessness, confusion, prostration, delirium,
shock, and coma. Streptomycin (the antibiotic of choice), gentamicin, tetracyclines, doxycycline, fluoroquinolones,
and chloramphenicol are effective in
treating plague. In the U.S., about 15
cases of plague are reported annually ,
primarily in western and southwestern
regions. If treated promptly, plague is
rarely fatal; however, in the U.S. about
1 in 7 people infected dies, usually because of delayed diagnosis or treatment.
ambulatory p. A mild form of bubonic plague.
black p. Plague.
bubonic p. Plague.
hemorrhagic p. A severe form of bubonic plague in which there is hemorrhage into the skin.
murine p. A plague infecting rats.
pneumonic p. A highly virulent form
of plague spread from person to person
by respiratory secretions. It occurs as a
sequela of bubonic plague or as a primary infection.
septicemic p. Severe bubonic plague;
plan
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septicemia may precede the formation
of buboes.
sylvatic p. Bubonic plague that is endemic among wild rodents and their
fleas.
plaintiff The person, entity, or party who
sues or brings a legal action against another and seeks damages or other legal
relief. SEE: defendant.
plait (plāt) To braid; to make separate
strands of tissue into a ropelike structure (e.g., during tendon repair).
plan The conscious design of desired future states and of the goals, objectives,
and activities required.
birth p. Written specifications for the
management of labor, delivery, and recovery as desired by the expectant
mother or couple and approved by the
physician or midwife. Components usually include pain management techniques, method of delivery, and family
participation. SEE: Lamaze technique;
Leboyer method.
dental care p. 1. The statement of
the goals, objectives, and procedures related to the dentist’s care for the patient, based on the medical history, oral
examination, and oral radiographs.
2. Third-party insurance that covers
part or all of the cost for regular dental
care.
health p. A corporation that provides
medical insurance.
individual education p. ABBR: IEP.
A federally required, individual program of goals and methods for addressing needs of students receiving special
education and related services in public
schools. They are required under the
provisions of federal legislation providing for a free and appropriate education
for individuals with disabilities, as
amended (Individuals with Disabilities
Education Act [IDEA]-PL 104-134,
Amended in 1997). The law mandates
that for each child receiving special education services under the act, a written
plan, involving input from teachers, service providers, and parents, will document the needs of the child, how those
special needs will be addressed, and
when and how the effectiveness of the
services will be evaluated.
individualized
family
service
p.
ABBR: IFSP. A written document, developed collaboratively by parents of
young children with disabilities and related service personnel, that describes
plans for intervention and educational
placement. Twenty-five percent of occupational therapists now practice in
school settings with the purpose of
meeting the legislated mandate for public schools to provide related services for
children with disabilities.
medical care p. The goals and objectives of the physician’s care and the
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
1798
plan
treatment
them.
instituted
to
accomplish
nursing care p. SEE: nursing care
plan.
treatment p. SEE: treatment plan.
planaria (plă-năr⬘ē-ă) Free-living flatworms of the Turbellaria class.
plan of care, care plan A description of
the goals and outcomes, prognosis, and
proposed interventions for a particular
patient, including criteria for discharge
and the optimal duration and frequency
of therapeutic interventions.
planchet (plăn⬘chĕt) A small, flat container or dish on which a radioactive
sample is placed.
plane (plān) [L. planus] 1. A flat or relatively smooth surface. 2. A flat surface
formed by making a cut, imaginary or
real, through the body or a part of it.
Planes are used as points of reference by
which positions of parts of the body are
indicated. In the human subject, all
planes are based on the body being in
an upright anatomical position. SEE: illus.; anatomical position. 3. A certain
stage, as in levels of anesthesia. 4. To
smooth a surface or rub away.
Addison’s p. [Christopher Addison,
Brit. anatomist, 1869– 1951] One of the
planes used as landmarks in thoracoabdominal topography.
alveolocondylar p. A plane tangent
SUPERIOR ASPECT
MIDSAGITTAL
PLANE
plane
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to the alveolar point with most prominent points on lower aspects of condyles
of the occipital bone.
axiolabiolingual p. A plane that
passes through an incisor or canine
tooth parallel to the long axis of the
tooth and in a labiolingual direction.
axiomesiodistal p. A plane that
passes through a tooth parallel to the
axis and in a mesiodistal direction.
Baer’s p. SEE: Baer’s plane.
bite p. A plane formed by the biting
surfaces of the teeth.
coccygeal p. The fourth parallel
plane of the pelvis.
coronal p. A vertical plane at right
angles to a sagittal plane. It divides the
body into anterior and posterior portions. SYN: frontal plane.
datum p. An assumed horizontal
plane from which craniometric measurements are taken.
Daubenton’s p. SEE: Daubenton’s
plane.
focal p. One of two planes through
the anterior and posterior principal foci
of a dioptric system and perpendicular
to the line connecting the two.
Frankfort horizontal p. SEE: Frankfort horizontal plane.
frontal p. Coronal p.
Hodge’s p. SEE: Hodge’s plane.
horizontal p. A transverse plane at
FRONTAL (CORONAL) PLANE
SAGITTAL
PLANE
SECTION OF
SMALL INTESTINE
LONGITUDINAL
SECTION
TRANSVERSE
PLANE
ANTERIOR
CROSS SECTION
POSTERIOR
INFERIOR ASPECT
BODY PLANES AND SECTIONS
short
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plane
1799
right angles to the vertical axis of the
body.
inclined p. of the pelvis Anterior and
posterior inclined planes of the pelvic
cavity, two unequal sections divided by
the sciatic spines. In the larger, anterior
section, the lateral walls slope toward
the symphysis and arch of the pubes;
the posterior walls slope in the direction
of the sacrum and coccyx. The anterior
inclined planes are the declivities over
which rotation of the occiput takes place
in the mechanism of normal labor.
inclined p. of a tooth Any sloping
surface of the cusp of a tooth.
intertubercular p. A horizontal plane
passing through the tubercles of the
crests of the ilia; lies approx. at the level
of the fifth lumbar vertebra.
Listing’s p. SEE: Listing’s plane.
median p. A vertical plane through
the trunk and head dividing the body
into right and left halves. SYN: midsagittal plane. SEE: plane for illus.
midsagittal p. Median p.
Morton’s p. SEE: Morton’s plane.
occlusal p. An imaginary plane extending from the incisal edge of the incisors along the tips of the cusps of the
posterior teeth to contact the cranium.
Although not a true plane, it represents
the mean of the curvature of the occlusal surface.
parallel p. of the pelvis The planes
intersecting the axis of the pelvic canal
at right angles. The first plane is that of
the superior strait; the second that extending from the middle of the sacral
vertebra to the level of the subpubic ligament. The third plane is at the level of
the spines of the ischia, and the fourth
plane is at the outlet.
p. of the pelvis Imaginary planes
touching the same parts of the pelvic canal on both sides.
p. of refraction A plane passing
through a refracted ray of light and
drawn perpendicular to the surface at
which refraction takes place.
p. of regard A plane through the fovea of the eye; fixation point.
sagittal p. A vertical plane through
the longitudinal axis of the body or part
of the body, dividing it into right and left
parts. If it is through the anteroposterior midaxis and divides the body into
right and left halves, it is called a median or midsagittal plane.
subcostal p. A horizontal plane passing through the lowest points of the
10th costal cartilages. It lies approx. at
the level of the third lumbar vertebra.
transverse p. A plane that divides
the body into a top and bottom portion.
treatment p. A plane in the concave
joint surface that defines the direction
of joint mobilization techniques. The
plane is perpendicular to a line drawn
Planorbis
from the axis of rotation in the convex
joint surface to the center of the concave
surface. Joint distraction techniques are
applied perpendicular to, and gliding
techniques parallel to, the treatment
plane.
vertical p. Any body plane perpendicular to a horizontal plane.
visual p. A plane passing the visual
axis of the eye.
planigraphy (plă-nı̆g⬘ră-fē) [⬙ ⫹ Gr.
graphein, to write] Tomography.
planimeter (plā-nı̆m⬘ĕ-tĕr) [⬙ ⫹ Gr.
metron, measure] An apparatus used
to measure the area of a plane figure by
passing a tracer around the boundaries.
planing (plā⬘nı̆ng) 1. Dermabrasion.
2. In dentistry, a meticulous deep scaling procedure designed to remove calculus, diseased cementum or dentin, microbial flora, and bacterial toxins on the
root surface of a tooth or in a gingival
pocket. The smooth, healthy root facilitates reattachment of the soft tissues of
the peridontium. SYN: root planing.
plankton (plănk⬘tŏn) [Gr. planktos, wandering] A freely floating organism —
one that is not anchored to a surface,
e.g., some algae, bacteria, crustaceans,
and diatoms.
planned parenthood The concept that a
couple or a woman may choose when to
conceive and give birth. This is, of
course, accomplished only by the careful
and proper use of some form of birth
control.
planning In the nursing process, the step
following nursing diagnosis. After the
nursing diagnoses have been established, the next action is noting the priority of the diagnoses and indicating the
actions that will accomplish the immediate and long-range goals of the nursing process. Specific nursing interventions are indicated, and the expected
outcomes of these actions are recorded
on the chart. This portion of the nursing
process is dynamic and will need to be
altered as the patient’s course evolves.
The evaluation of the effectiveness of
the nursing process will be essential to
restating the plan for administering
nursing care. SEE: nursing process;
nursing assessment; evaluation; nursing
intervention; problem-oriented medical
record.
planocellular
(plā⬙nō-sĕl⬘ū-lăr)
[L.
planus, plane, ⫹ cellula, cell] Composed of flat cells.
planoconcave (plā⬙nō-kŏn⬘kāv) [⬙ ⫹
concavus, hollow] An optical lens that
is flat on one side and concave on the
other.
planoconvex (plā⬙nō-kŏn⬘vĕks) [⬙ ⫹ L.
convexus, arched] An optical lens that
is flat on one side and convex on the
other.
Planorbis (plăn-or⬘bı̆s) A genus of freshwater snails that is the intermediate
top of rh
base of rh
short
standard
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planotopokinesia
plasma
top of rh
base of rh
the lining of an artery, formed by the
abnormal accumulation of lipids (fats)
and sometimes calcium.
bacterial p. Dental p.
dental p. A biofilm that accumulates
and grows on the crowns of teeth.
Plaque is colorless, transparent, and the
forerunner of dental caries and periodontal disease. Measures to prevent
plaque buildup include daily self-care
of the teeth, careful use of dental floss,
and periodic prophylaxis by a dentist or
dental hygienist.
TREATMENT: Treatment should include removal on a daily basis. Brushing and flossing are typical methods of
plaque removal. Additional techniques
may include water irrigation, chemical
plaque control, and auxiliary oral hygiene aids. SEE: calculus; caries; periodontal disease; periodontitis.
mucous p. Condyloma latum.
senile p. Accumulations of bundled
amyloid fibrils surrounding normal and
damaged neurons in the brain, a finding
on pathological inspection of brain tissue from patients with Alzheimer’s dementia.
-plasia [Gr. plasis, molding] Combining
form used as a suffix indicating formation, growth, proliferation.
plasm (plăzm) [LL. plasma, form, mold]
Plasma.
plasm- [Gr. plasma, anything formed]
Combining form meaning living substance, tissue.
plasma (plăz⬘mă) [LL. plasma, form,
mold] 1. An ointment base of glycerol
and starch. 2. The liquid part of blood
and of lymph. SYN: blood p.
Plasma forms 52% to 62% of the total
blood volume and is a transport medium
and a medium for chemical reactions. It
is about 91.5% water, and about 7% protein, including albumin, globulins, and
the clotting factors. Also found in
plasma are electrolytes that determine
osmotic pressure and pH balance, nutrients and waste products, and hormones. Most carbon dioxide is transported in plasma in the form of
bicarbonate ions. Plasma from which
clotting factors have been removed is
called serum.
antihemophilic factor p. Human
plasma in which factor VIII, the antihemophilic globulin, has been preserved; used to correct temporarily the
bleeding tendency in some forms of hemophilia. SEE: hemophilia.
blood p. Plasma (2).
fresh frozen p. ABBR: FFP. The
fluid portion of one unit of human blood
that has been centrifuged, separated,
and frozen solid within 6 hours of collection. SEE: blood component therapy.
hyperimmune p. Plasma with a high
titer of a specific antibody, administered
short
standard
1800
host for some species of schistosomal
blood flukes.
planotopokinesia (plā⬙nō-tŏp⬙ō-kı̄-nē⬘zēă) [⬙ ⫹ topos, place, ⫹ kinesis, movement] Loss of orientation in space.
plant (plănt) [L. planta, a sprout] An organism that contains chlorophyll and
synthesizes carbohydrates and oxygen
from carbon dioxide and water. Plants
make up one of the five kingdoms of living things. SEE: chlorophyll.
plantago seed (plăn-tā⬘gō) The cleaned,
dried, ripe seed of Plantago psyllium or
P. indica. It is used as a cathartic, but
usually in a powdered form rather than
in the form of whole seeds.
plantalgia (plăn-tăl⬘jē-ă) [L. planta, sole
of the foot, ⫹ Gr. algos, pain] Pain in
the sole of the foot.
planta pedis (plăn⬘tă pē⬘dŭs) pl. plantae
[L.] The sole of the foot.
plantar (plăn⬘tăr) Concerning the sole of
the foot.
plantar flexion Extension of the foot so
that the forepart is depressed with respect to the position of the ankle. SEE:
dorsiflexion.
plantaris (plăn-tăr⬘ı̆s) [L.] A long slim
muscle of the calf between the gastrocnemius and soleus. It is sometimes
double and at other times missing.
plantation (plăn-tā⬘shŭn) [L. plantare,
to plant] Insertion of a tooth into the
bony socket from which it may have
been removed by accident, or transplantation of a tooth into the socket from
which a tooth has just been removed.
The transplanted tooth may come from
the patient or a donor.
plantigrade (plăn⬘tı̆-grād) [L. planta,
sole of the foot, ⫹ gradi, to walk] A
type of foot posture in which the entire
sole of the foot is placed on the ground
in walking, as in the bear, rabbit, or human.
planula (plăn⬘ū-lă) The larval stage of a
coelenterate.
planum (plā⬘nŭm) pl. plana [L.] A flat
or relatively smooth surface; a plane.
nuchal p. The outer surface of the occipital bone between the foramen magnum and superior nuchal line.
occipital p. The outer surface of the
occipital bone lying above the superior
nuchal line.
popliteal p. A smooth triangular
area on the posterior surface of distal
end of femur. It is bordered by the medial and lateral supracondylar lines and
forms the floor of the popliteal fossa.
sternal p. The anterior or ventral
surface of the sternum.
planuria (plā-nū⬘rē-ă) [Gr. plane, wandering, ⫹ ouron, urine] The voiding
of urine from an abnormal passage of
the body.
plaque (plăk) [Fr., a plate] A patch on
the skin or on a mucous surface.
atheromatous p. An obstruction in
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
plasma
1801
to create passive immunity to the antigen.
normal human p. Pooled plasma
from a number of human donors. The
plasma is selected from screened donors
and sterilized.
p. skimming The natural separation
of red blood cells from plasma at bifurcations in the vascular tree, dividing the
blood into relatively concentrated and
relatively dilute streams.
plasmablast
(plăz⬘mă-blăst)
[LL.
plasma, form, mold, ⫹ Gr. blastos,
germ] The undifferentiated cell that
will mature into a B lymphocyte and ultimately into a plasma cell.
plasmacytoma (plăz⬙mă-sı̄⬘tō⬘mă) [⬙ ⫹
⬙ ⫹ oma, tumor] A tumor composed of
plasma cells. SEE: multiple myeloma.
plasmacytosis (plăz⬙mă-sı̄-tō⬘sı̆s) [⬙ ⫹
⬙ ⫹ osis, condition] An excess of
plasma cells in the blood.
plasma exchange therapy The removal
of plasma from a patient (usually to
treat an immmunologically mediated
illness such as thrombotic thrombocytopenic purpura or myasthenia gravis)
and its replacement with normal
plasma. Plasma exchange therapy can
also be used to replace excessively
viscous plasma in patients with Waldenström’s macroglobulinemia. Pathological (disease-causing) antibodies, immune complexes, and protein-bound
toxins are removed from the plasma by
plasma exchange.
Immunoglobulin infusions are an alternative to plasma exchange when
treating some immunological illnesses,
including Guillain-Barré syndrome and
chronic inflammatory demyelinating
polyneuropathy. SYN: plasmapheresis.
plasmagene (plăz⬘mă-jēn⬙) [⬙ ⫹ Gr.
gennan, to produce] A cytoplasmic hereditary determiner.
plasmalemma (plăz⬙mă-lĕm⬘ă) [⬙ ⫹
Gr. lemma, husk] Plasma, or cell, membrane.
plasmapheresis (plăz⬙mă-fĕr-ē⬘sı̆s) [⬙ ⫹
Gr. aphairesis, separation] Plasma exchange therapy.
plasma protein fraction A standard sterile preparation of serum albumin and
globulin obtained by fractionating
blood, serum, or plasma from healthy
human donors and testing for absence
of hepatitis B surface antigen. It is used
as a blood volume expander.
plasmatherapy (plăz⬙mă-thĕr⬘ă-pē) [⬙
⫹ Gr. therapeia, service] Plasma exchange therapy.
plasmatic (plăz-măt⬘ı̆k) 1. Relating to
plasma. 2. Formative or plastic.
Plasmodium
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plasma volume expander A high– molecular-weight compound in a solution
suitable for intravenous use. The materials, such as dextran or certain proteins, are used in treating shock caused
by loss of blood volume.
plasmid (plăz⬘mı̆d) A piece of extrachromosomal, double-stranded DNA
found in most bacteria. Plasmids replicate when a bacterium divides and are
passed to subsequent cells. The products of plasmid genes are enzymes that
provide resistance to antibiotics or that
synthesize bacteriocins or other toxins.
SYN: episome. SEE: bacteriocin; transposon.
plasmin (plăz⬘mı̆n) A fibrinolytic enzyme derived from its precursor plasminogen.
plasminogen (plăz-mı̆n⬘ō-jĕn) A protein
found in many tissues and body fluids;
important in preventing fibrin clot formation.
plasminogen activator inhibitor-1 A protein that degrades extracellular tissues.
It has been linked to the invasive and
metastatic spread of cancers.
plasmocyte, plasmacyte (plăz⬘mă-sı̄t) [⬙
⫹ Gr. kytos, cell] The malignant cells
found in the bone marrow and occasionally in the blood of persons with multiple myeloma.
plasmodesmata
(plăz⬙mō-dĕz⬘mă-tă)
sing., plasmodesma [⬙ ⫹ Gr. desmos,
bond] Tunnels in plant cell walls.
These facilitate communication between cells.
plasmodial (plăz-mō⬘dē-ăl) Concerning
plasmodia.
plasmodicidal (plăz⬙mō-dı̆-sı̄⬘dăl) [⬙ ⫹
Gr. eidos, form, shape, ⫹ L. caedere, to
kill] Lethal to plasmodia.
Plasmodium (plăz-mō⬘dē-ŭm) A genus
of protozoa belonging to subphylum
Sporozoa, class Telosporidia; includes
causative agents of malaria in humans
and lower animals. SEE: malaria; mosquito.
P. falciparum The causative agent of
malignant (falciparum) malaria. SEE:
illus.
plasma very-long-chain fatty acid assay
ABBR: VLCFA assay. A blood test to
detect adrenoleukodystrophy in infants
suspected of the disease or adrenomyeloneuropathy in adults with progressive
paraparesis.
PLASMODIUM FALCIPARUM
Sporozoite ring forms in red blood cells
(⫻1000)
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Plasmodium
1802
P. malariae The causative agent of
quartan malaria.
P. ovale The causative agent of benign tertian or ovale malaria.
P. vivax The causative agent of benign tertian or vivax malaria.
plasmodium (plăz-mō⬘dē-ŭm) pl. plasmodia [LL. plasma, form, mold, ⫹
Gr. eidos, form, shape] 1. A multinucleate mass of naked protoplasm, occurring commonly among slime molds.
2. An organism in the genus Plasmodium.
plasmogamy (plăs-mŏg⬘ă-mē) [⬙ ⫹ Gr.
gamos, marriage] The fusion of cells.
plasmolysis (plăz-mŏl⬘ı̆-sı̆s) [⬙ ⫹ Gr. lysis, dissolution] Shrinking of cytoplasm
in a living cell caused by loss of water
by osmosis.
plasmorrhexis (plăz⬙mō-rĕk⬘sı̆s) [⬙ ⫹
Gr. rhexis, rupture] The rupture of a
cell with loss of its contents. SYN: erythrocytorrhexis.
plasmotomy (plăz-mŏt⬘ō-mē) [⬙ ⫹ Gr.
tome, incision] Cell division with unequal separation of cytoplasm.
plastein (plăs⬘tē-ı̆n) A massive polypeptide formed by the hydrolysis of proteins
and the subsequent recombination of
amino acid esters. Plasteins can be derived from nonconventional sources of
protein (e.g., cassava leaves or other
plants) and used to make protein-rich
foods.
plaster [Gr. emplastron] 1. A material,
usually plaster of Paris, that is applied
to a part and allowed to harden in order
to immobilize the part or to make an impression. In many settings, plaster of
Paris has been replaced with synthetic
cast materials, such as fiberglass. 2. A
topical preparation in which the constituents are formed into a tenacious
mass of substance harder than an ointment and spread upon muslin, linen,
skin, or paper.
dental p. A powder, when mixed with
water, that hardens to form a stonelike
investment or model material. It is composed of a hemihydrate of gypsum
(CaSO4 · 2H2O), which differs in compression strength and expansion coefficient according to how it is treated and
rehydrated. There are four classes of
dental plaster, with differing uses as
materials for casts, impressions, or
stone models, based on the differences
of characteristics.
mustard p. Sinapsim.
p. of Paris Gypsum cement, hemihydrated calcium sulfate (CaSO4 ·
2H2O), mixed with water to form a paste
that sets rapidly; used to make casts
and stiff bandages.
salicylic acid p. A uniform mixture of
salicylic acid spread on an appropriate
base such as paper, cotton, or fabric. It
is applied topically for use as a keratolytic agent.
plate
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plastic (plăs⬘tı̆k) [Gr. plastikos, fit for
molding] 1. Capable of being molded.
2. Contributing to building tissues.
plasticity (plăs-tı̆s⬘ı̆-tē) 1. The ability to
be molded. 2. The ability of tissues to
grow, to adapt, or to integrate with others during development, after trauma,
or after an illness.
plastid (plăs⬘tı̆d) [Gr. plastos, formed]
An organelle in plant cells. It includes
chloroplasts (which contain chlorophyll), leukoplasts (colorless), chromoplasts (which contain pigment), and
amyloplasts (which store starch). Chloroplasts are the site of photosynthesis.
-plasty Suffix meaning surgical repair.
plate (plāt) [Gr. plate, flat] 1. A thin,
flattened part or portion, such as a flattened process of a bone. SYN: lamella;
lamina. 2. An incorrect reference to a
full denture. 3. A shallow covered dish
for culturing microorganisms. 4. To inoculate and culture microorganisms in
a culture plate.
alar plate In the embryo, the upper
(dorsal) half of the neural tube (above
the sulcus limitans). SYN: alar lamina
of neural tube.
belay p. A metal, steel, or aluminum
plate that has one or more slots in it,
designed to weave a rope through, to
create friction with a carabiner.
bite p. In dentistry, a plate made of
some suitable plastic material into
which the patient bites in order to have
a record of the relationship between the
upper and lower jaws. The device may
be reinforced with wire and used as a
splint in the mouth or to treat temporomandibular joint difficulties. SYN: interocclusal record; occlusal template.
bone p. A flat, round or oval decalcified bone or metal disk, employed in
pairs, used in approximation.
cortical p. The compact layers of
bone forming the surfaces of the alveolar processes of the mandible and maxilla.
cribriform p. 1. The thin, perforated,
medial portion of the horizontal plate of
the ethmoid bone; the olfactory foramina are passages for the olfactory nerve.
2. Alveolar bone, the spongy bone that
makes up the wall of the socket for a
tooth; found in the maxillae and mandible.
dental p. An old term for the denture
base of metal or acrylic material that
rests on the oral mucosa and to which
artificial teeth are attached; by extension, incorrectly used to mean the complete denture.
epiphyseal p. The thin layer of cartilage between the epiphysis and the
shaft of a bone. Growth in length of the
bone occurs at this layer. SYN: growth
plate.
equatorial p. The platelike mass of
short
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plate
1803
chromosomes at the equator of the spindle in cell division.
floor p. In the embryonic neural
tube, the wedge of cells in the ventral
midline. These cells are primitive radial
glia and do not give rise to neurons. The
ventral commissures and decussations
eventually develop through this structure. SYN: ventral plate.
force p. A device for determining
weight-bearing loads and biomechanical forces placed on the foot during
walking or running.
growth p. Epiphyseal p.
medullary p. The central portion of
the ectoderm in the embryo developing
into the neural canal.
neural p. A thickened band of ectoderm along the dorsal surface of an embryo. The nervous system develops from
this tissue.
palate p. The part of the palatine
bone forming the dorsal half of the roof
of the mouth.
polar p. In some cells, the flattened
platelike bodies seen at the end of the
spindle during mitosis.
pterygoid p. Either of a pair of thin,
bony processes that arise from the sphenoid bone. They are termed medial and
lateral pterygoid plates on each side,
serve to bound the infratemporal fossa,
and give origin to muscles of mastication.
pusher p. A device that moves fluids
in a specific direction.
tarsal p. The dense connective tissue
structure that supports the eyelid. It
was formerly called tarsal cartilage;
however, it is not true cartilage.
ventral p. Floor plate.
plateau (plă-tō⬘) 1. An elevated and usually flat area; a steady and consistent
fever appears as a plateau on the patient’s chart of vital signs. 2. The stage
in training or skill acquisition when
progress occurs at a very slow or flat
rate in comparison with earlier phases.
ventricular p. The flat portion of the
record of intraventricular pressure during the end of the ejection phase of ventricular systole.
platelet (plāt⬘lĕt) [Gr. plate, flat] A
round or oval disk, 2 to 4 ␮m in diameter, found in the blood of vertebrates.
Platelets number 130,000 to 400,000/
mm3. They are fragments of megakaryocytes, large cells found in the bone
marrow. SYN: thrombocyte. SEE: illus.;
blood for illus.; megakaryocyte for illus.;
thrombopoietin.
FUNCTION: Platelets contribute to
chemical blood clotting and to other aspects of hemostasis. Platelet factors are
the chemicals released by platelets to
initiate the first stage of (intrinsic pathway) chemical clotting. When a capillary ruptures, platelets adhere to each
other and to the cut edges of the vessel,
platinosis
top of rh
base of rh
forming a platelet plug. Blood clotting
may be beneficial (e.g., in preventing
blood loss from wounds) or may be
harmful when it occurs within arteries
or veins inside the body (e.g., during coronary thrombosis). Blood clotting is a
positive feedback cascade that may continue and occlude an unbroken vessel.
DISORDERS: Thrombocytopenia (reduced platelet count) occurs in acute infections, anaphylactic shock, and certain hemorrhagic diseases and anemias.
Thrombocytosis (increased platelet
count) occurs after operations, esp. splenectomy, and after violent exercise and
tissue injury.
platelet-activating
factor
antagonist
Any drug that blocks the effects of platelet-activating factor on inflammatory or
allergic diseases and conditions.
platelet concentrate Platelets prepared
from a single unit of whole blood or
plasma and suspended in a specific volume of the original plasma. This blood
fraction must be used before the expiration date shown on its label. Platelets
are stored at room temperature (22⬚C)
either in plasma or in a concentrated
form as platelet-rich plasma.
platelet function assay-100 A test of the
ability of platelets to occlude a small aperture when whole blood is forced
through it under conditions of high
shear stress. The time required for
blood to occlude the aperture of the test
device is known as the closure time. The
test is used to evaluate diseases and
conditions in which platelets may function abnormally, e.g., in menstruating
women with menorrhagia or in patients
suspected of having von Willebrand’s
disease.
plateletpheresis (plāt-lĕt-fĕr-ē⬘sı̆s) The
separation of platelets from other components of whole blood (e.g. for use in
transfusion or to treat hematologic disease).
platelet transfusion refractoriness A
failure of circulating platelet levels to
rise after platelet transfusion. Alloimmunization against platelet antigens,
disseminated intravascular coagulation, fever, hypersplenism, and sepsis
are among the potential causes. A typical platelet transfusion should normally
raise platelet counts by more than
20,000 platelets/microliter.
-platin (plăt-ı̆n) [Fm. platin(um)] A suffix used in pharmacology to designate
any chemotherapeutic agent that contains platinum.
plating In bacteriology, inoculation of liquefiable, solid media (gelatin or agar)
with microorganisms and pouring of
medium into a shallow flat dish.
platinic (plă-tı̆n⬘ı̆k) Pert. to a compound
containing quadrivalent platinum.
platinosis (plă-tı̆-nō⬘sı̆s) Cutaneous and
short
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1804
platinous
platymorphia
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SKIN IS CUT AND
BLOOD ESCAPES FROM A
CAPILLARY AND AN
ARTERIOLE.
CAPILLARY
ARTERIOLE
PLATELETS
FIBRIN
IN THE CAPILLARY, PLATELETS
STICK TO THE RUPTURED WALL
AND FORM A PLATELET PLUG.
IN THE ARTERIOLE, A FIBRIN
CLOT FORMS.
CLOT RETRACTION PULLS THE
EDGES OF THE WOUND TOGETHER.
PLATELET PLUG FORMATION AND CLOTTING
respiratory allergic reactions to exposure to complex salts of platinum.
platinous (plăt⬘ı̆-nŭs) A compound containing divalent platinum.
platinum (plăt⬘ı̆-nŭm) [Sp. platina]
SYMB: Pt. A heavy silver-white metal;
atomic weight 195.09; atomic number
78; specific gravity 21.45.
platy- [Gr. platys, broad] Combining
form meaning broad or flat.
platybasia (plăt⬙ē-bā⬘sē-ă) A developmental defect of the skull in which the
floor of the posterior fossa of the skull
around the foramen magnum protrudes
upward.
platycephalic, platycephalous (plăt⬙ē-sēfăl⬘ı̆k, −sĕf⬘ă-lŭs) [⬙ ⫹ kephale, head]
Having a wide skull with a vertical index less than 70.
platycephaly (plăt⬙ē-sĕf⬘ă-lē) Flattening
of the skull. SYN: platycrania.
platycnemia (plăt-ı̆k-nē⬘mē-ă) [⬙ ⫹
kneme, leg] 1. The condition of having
an unusually broad tibia. 2. A broadlegged condition.
platycoria, platycoriasis (plăt⬙ē-kor-ē⬘ă,
−kor-ı̄⬘ă-sı̆s) [⬙ ⫹ kore, pupil] Mydriasis.
platycrania (plăt⬙ē-krā⬘nē-ă) [⬙ ⫹ kranion, skull] Platycephaly.
platyglossal (plăt⬙ē-glŏs⬘ăl) [Gr. platys,
broad, ⫹ glossa, tongue] Having a
broad, flat tongue.
platyhelminth (plăt⬙ē-hĕl⬘mı̆nth) The
common name for any flatworm.
Platyhelminthes (plăt⬙ē-hĕl-mı̆n⬘thēz) [⬙
⫹ helmins, worm] A phylum of flatworms including the classes Turbellaria, Trematoda (flukes), and Cestoidea (tapeworms). The last two are
parasitic and include many species of
medical importance. SEE: Cestoda; Cestoidea; fluke; tapeworm; trematode.
platyhieric (plăt⬙ē-hı̄-ĕr⬘ı̆k) [⬙ ⫹ hieron,
sacrum] Having a broad sacrum with a
sacral index over 100.
platymeric (plăt⬙ē-mē⬘rı̆k) [⬙ ⫹ meros,
thigh] Having an unusually broad femur.
platymorphia (plăt⬙ē-mor⬘fē-ă) [⬙ ⫹
short
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1805
platyopia
morphe, form] Having an eye with a
shortened anteroposterior diameter,
which results in hyperopia.
platyopia (plăt⬙ē-ō⬘pē-ă) [⬙ ⫹ ops, face]
Having a very broad face, with a nasomalar index of less than 107.5.
platyopic (plăt⬙ē-ŏp⬘ı̆k) Having a broad,
flattened face.
platypellic,
platypelvic,
platypelloid
(plăt⬙ē-pĕl⬘ı̆k, −vı̆k, −oyd) [⬙ ⫹ pella, a
basin] Having a broad pelvis. SEE: pelvis, platypellic.
platypnea (plă⬙tı̆p⬘nē-ă) [⬙ ⫹ pnoia,
breath] Shortness of breath, dyspnea,
only when the patient is upright or
seated. SEE: orthopnea.
platyrrhine (plăt⬘ı̆r-ı̄n) [⬙ ⫹ rhis, nose]
1. Having a very wide nose in proportion to length. 2. Pert. to a skull with a
nasal index between 51.1 and 58.
platysma myoides
(plă-tı̆z⬘mă mı̄oy⬘dēz) [Gr. platysma, plate, ⫹ mys,
muscle, ⫹ eidos, form, shape] A
broad, thin, platelike layer of muscle
that extends from the fascia of both
sides of the neck to the jaw and muscles
around the mouth. It acts to wrinkle the
skin of the neck and depress the jaw.
platyspondylia
(plăt⬙ē-spŏn-dı̆l⬘ē-ă)
Flatness of the vertebral bodies.
platystencephaly (plăt⬙ı̆-stĕn-sĕf⬘ă-lē) [⬙
⫹ kephale, head] Having a skull wide
at the occiput.
Plavix SEE: clopidogrel.
play 1. Involvement in a sport, amusement, or any form of recreation, esp. an
activity other than that in which one is
usually engaged as an occupation. From
the medical standpoint, it is important
that the recreational activity be enjoyable and that participation in it be safe
and satisfactory. 2. Unimpeded motion,
as of a joint.
play therapy The use of play, esp. with
dolls and toys, to allow children to express their feelings. This may permit insight into their thought processes that
could not be obtained through verbal
communication.
pleasure [L. placere, to please] The feeling of being delighted or pleased.
pleasure principle In psychoanalytic theory, the idea that people strive to avoid
pain, hunger, and physical or psychological stresses in favor of pleasant experiences, e.g., food, sex, and narcissistic
satisfaction
pledget (plĕj⬘ĕt) [origin uncertain] 1. A
small, flat compress, usually of gauze or
absorbent cotton, used to apply or absorb fluid, to protect, or to exclude air.
2. A small spherical mass of cotton
about 1⁄8 in. (3 mm) in diameter that is
used with forceps for topical application
of medicinal substances, particularly in
dentistry.
-plegia (plē⬘jē-ă) [Gr. plege, stroke]
Combining form used as a suffix meaning paralysis, stroke.
plessimeter
top of rh
base of rh
pleio-, pleo-, plio-
Combining forms
meaning more.
pleiotropia (plı̄⬙ō-trō⬘pē-ă) [Gr. pleion,
more, ⫹ trope, turn] The ability of a
gene to have many effects. SYN: pleiotropism.
pleiotropism (plı̄-ŏt⬘rō-pı̆zm) [⬙ ⫹ ⬙ ⫹
−ismos, condition] Pleiotropia.
Pleistophora (plı̄-stō-fŏ⬘ră) A genus of
microsporidia that usually parasitizes
fish. SEE: microsporidiosis.
pleochroic (plē⬙ō-krō⬘ı̆k) [Gr. pleon,
more, ⫹ chroia, color] Pleochromatic.
pleochroism (plē-ŏk⬘rō-ı̆zm) [⬙ ⫹ ⬙ ⫹
−ismos, condition] The property of a
crystal that produces different colors
when light passes through it at different
angles.
pleochromatic (plē⬙ō-krō-măt⬘ı̆k) [⬙ ⫹
chroma, color] Pert. to the property of
crystals and some other bodies that
show different colors when seen from
different axes. SYN: pleochroic.
pleocytosis (plē⬙ō-sı̄-tō⬘sı̆s) [⬙ ⫹ kytos,
cell, ⫹ osis, condition] An excessive
number of cells in a body fluid; used esp.
to denote excessive lymphocytes in the
cerebrospinal fluid.
pleomorphic (plē-ō-mor⬘fı̆k) [⬙ ⫹ morphe, form] Having many shapes.
pleomorphism (plē-ō-mor⬘fı̆zm) [⬙ ⫹ ⬙
⫹ −ismos, condition] Polymorphism.
pleomorphous (plē-ō-mor⬘fŭs) Having
many shapes or crystallizing into several forms.
pleonasm (plē⬘ō-năzm) [Gr. pleonasmos,
exaggeration] 1. The state of having
more than the normal number of organs
or parts. 2. The use of more words than
necessary to express an idea.
pleonosteosis (plē⬙ŏn-ŏs⬙tē-ō⬘sı̆s) [Gr.
pleon, more, ⫹ osteon, bone, ⫹ osis,
condition] Premature and excessive ossification of bones.
plerocercoid
(plĕr-ō-sĕr-kŏyd)
The
wormlike larvae of certain tapeworms,
which develop in secondary hosts.
Plesiomonas shigelloides
(plē-sē-ōmŏn⬘ăs, ŏm⬘ă shı̆-gĕl-oi⬘dēz, ō⬘ı̆-) [Gr.
Gr. plesios, close, nearby ⫹ ⬙ ⫹ ⬙] A
gram-negative facultatively anaerobic
rod-shaped bacterium. It is thought to
be a cause of gastroenteritis/infectious
diarrhea acquired from contaminated
water.
plesiomorphism
(plē⬙sē-ō-mor⬘fı̆zm)
[Gr. plesios, close, ⫹ morphe, form, ⫹
−ismos, condition] Similarity of form.
plesiopia (plē⬙sē-ō⬘pē-ă) [⬙ ⫹ ops, eye]
An increase in the convexity of the lens
of the eye.
plessesthesia (plĕs⬙ĕs-thē⬘zē-ă) [Gr.
plessein, to strike, ⫹ aisthesis, sensation] Palpatory percussion with the left
middle finger pressed against the body
and the right index finger percussing in
contact with the left finger.
plessimeter (plĕs-sı̆m⬘ĕ-tĕr) [⬙ ⫹ metron, measure] Pleximeter.
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
plessor
pleurisy
top of rh
base of rh
pulmonary tuberculosis, asbestosis, and
other lung diseases in which the pleura
becomes thickened and the pleural
space may be obliterated.
p. reaction Thickening of the pleura,
or of the pleural shadow, on an x-ray,
which is an indication of pleural disease, pleural effusion, or infiltration by
cancer.
pleuralgia (ploo-răl⬘jē-ă) [⬙ ⫹ algos,
pain] Pain in the pleura, or in the side.
SYN: intercostal neuralgia.
pleurectomy (ploo-rĕk⬘tō-mē) [⬙ ⫹ ektome, excision] Excision of part of the
pleura.
pleurisy (ploo⬘rı̆s-ē) [Gr. pleuritis] Inflammation of the visceral and parietal
pleurae that surround the lungs and
line the thoracic cavity. It may be primary or secondary; unilateral, bilateral,
or local; acute or chronic; fibrinous, serofibrinous, or purulent. Common causes
of pleurisy include viral infections,
pneumonia, pulmonary embolism, rib
fracture, and serositis from autoimmune diseases. SYN: pleuritis. SEE:
Nursing Diagnoses Appendix.
SYMPTOMS: Sharp stabbing pain exacerbated by breathing is characteristic.
PATIENT CARE: Respiratory function
is monitored by auscultation, observation of breathing pattern, and oximetry.
The patient is positioned in the high
Fowler position to facilitate chest expansion. Rest is encouraged. Deep
breathing using incentive spirometry is
encouraged every 1 to 2 hr to prevent
atelectasis. To reduce discomfort when
coughing, the patient should splint the
chest with a pillow and administer analgesic drugs and use noninvasive measures, such as local application of warm
or cool compresses. Respiratory toilet is
provided if secretions are present. Rest
is recommended. Prescribed medical
regimens are carried out, with treatment directed at the underlying cause,
and the patient’s responses evaluated.
Severe pain may be managed with intercostal nerve block. Thoracentesis
may be required if pleural effusion is
present.
adhesive p. Pleurisy in which the exudate causes the parietal pleura to adhere to the visceral. If this is extensive,
the pleural space is obliterated.
diaphragmatic p. Inflammation of
the diaphragmatic pleura. Symptoms
include intense pain under the margin
of the ribs, sometimes referred into the
abdomen, with tenderness upon pressure; thoracic breathing; tenderness
over the phrenic nerve referred to the
supraclavicular region in the neck on
the same side; hiccough; and extreme
dyspnea.
dry p. A condition in which the pleural membrane is covered with a fibrinous exudate.
short
standard
1806
plessor (plĕs⬘or) [Gr. plessein, to strike]
Plexor.
plethora (plĕth⬘ō-ră) [Gr. plethore, fullness] 1. Overfullness of blood vessels or
of the total quantity of any fluid in the
body. SEE: sanguine. 2. Congestion
causing distention of the blood vessels.
plethoric (plĕ-thor⬘ı̆k, plĕth⬘ō-rı̆k) Pert.
to, or characterized by, plethora; overfull.
plethysmograph (plē-thı̆z⬘mō-grăf) [Gr.
plethysmos, to increase, ⫹ graphein, to
write] A device for finding variations in
the size of a part owing to variations in
the amount of blood passing through or
contained in the part.
body p. A body box used to measure
lung volume and pressure.
impedance p. A device that uses gasto-tissue ratio to set an alarm or measure a volume.
plethysmography
(plĕth⬙ı̆z-mŏg⬘ră-fē)
The use of a plethysmograph to record
the changes in volume of an organ or extremity.
air displacement p. A technique for
measuring body composition (body volume and percentage of body fat) that relies on the relative volume and pressure
of gas displaced by the body when it is
placed inside a plethysmograph.
pleur-, pleuro- [Gr. pleura, rib, side]
Combining forms meaning pleura, side,
rib.
pleura (ploo⬘ră) pl. pleurae [Gr., side] A
serous membrane that enfolds both
lungs and is reflected upon the walls of
the thorax and diaphragm. The pleurae
are moistened with a serous secretion
that reduces friction during respiratory
movements of the lungs. SEE: effusion,
pleural; mediastinum; thorax.
costal p. Parietal pleura.
mediastinal p. The portion of the parietal pleura that extends to cover the
mediastinum.
parietal p. The serous membrane
that lines the chest cavity; it extends
from the mediastinal roots of the lungs
and covers the sides of the pericardium
to the chest wall and backward to the
spine. The visceral and parietal pleural
layers are separated only by a lubricating secretion. These layers may become
adherent or separated by air or by blood,
pus, or other fluids, when the lungs or
chest wall are injured or inflamed. SYN:
costal p.
visceral p. The pleura that covers the
lungs and enters into and lines the interlobar fissures. It is loose at the base
and at the sternal and vertebral borders
to allow for lung expansion.
pleuracotomy (ploor⬙ă-kŏt⬘ō-mē) [⬙ ⫹
tome, incision] Incision into the pleura
through the chest wall.
pleural (ploo⬘răl) [Gr. pleura, side] Concerning the pleura.
p. fibrosis A condition occurring in
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pleurisy
1807
p. with effusion Pleural effusion.
tuberculous p. Inflammation of the
pleura as a result of tuberculosis. The
effusion may be bloody.
typhoid p. Pleurisy with symptoms
of typhoid.
pleuritic (ploo-rı̆t⬘ı̆k) [Gr. pleuritis, pleurisy] Relating to, or resembling, pleurisy.
pleuritis (ploo-rı̄⬘tı̆s) [Gr.] Pleurisy.
pleuritogenous (ploor⬙ı̆-tŏj⬘ĕ-nŭs) [⬙ ⫹
gennan, to produce] Causing pleurisy.
pleurocele (ploo⬘rō-sēl) [Gr. pleura, side,
⫹ kele, tumor, swelling] 1. Hernia of
the lungs or pleura. 2. A serous pleural
effusion.
pleurocentesis (ploo⬙rō-sĕn-tē⬘sı̆s) [⬙ ⫹
kentesis, a piercing] Thoracentesis.
pleuroclysis
(ploo-rŏk⬘lı̆-sı̆s)
[⬙
⫹
klysis, a washing] Injection and removal of fluid into the pleural cavity to
wash it out.
pleurodesis (ploo⬙rō-dē⬘sı̆s) [⬙ ⫹ desis,
binding] Production of adhesions between the parietal and visceral pleura;
it is usually done surgically or by instillation of drugs or chemicals. This
method is used to treat recurrent pneumothorax and malignant pleural effusions.
pleurodynia (ploo⬙rō-dı̆n⬘ē-ă) [⬙ ⫹
odyne, pain] Pain of sharp intensity in
the intercostal muscles due to chronic
inflammatory changes in the chest fasciae; pain of the pleural nerves.
epidemic p. Bornholm disease.
pleurogenic, pleurogenous
(ploo⬙rōjĕn⬘ı̆k, ploo-rŏj⬘ĕn-ŭs) Arising in the
pleura.
pleurography (ploo-rŏg⬘ră-fē) [⬙ ⫹
graphein, to write] Radiographical examination of the lungs and pleura.
pleurohepatitis (ploo⬙rō-hĕp⬙ă-tı̄⬘tı̆s) [⬙
⫹ hepatos, liver, ⫹ itis, inflammation] Inflammation of the pleura and
liver.
pleurolith (ploo⬘rō-lı̆th) [⬙ ⫹ lithos,
stone] A stone between the pleura.
pleurolysis (ploo-rŏl⬘ı̆-sı̆s) [⬙ ⫹ lysis,
dissolution] Loosening of parietal
pleura from intrathoracic fascia to facilitate contraction of the lung or artificial
pneumothorax.
pleuropericarditis
(ploo⬙rō-pĕr⬙ı̆-kărdı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹ ⬙ ⫹ itis, inflammation] Pleuritis accompanied by pericarditis.
pleuropneumonia (ploo⬙rō-nū-mō⬘nē-ă)
[⬙ ⫹ pneumon, lung] Pleurisy accompanied by pneumonia.
pleurorrhea (ploor⬙ō-rē⬘ă) [⬙ ⫹ rhoia,
flow] Effusion of fluid into the pleura.
pleuroscopy (ploo-rŏs⬘kō-pē) [⬙ ⫹ skopein, to examine] Inspection of the
pleural cavity with an endoscope inserted through an incision into the thorax.
pleurothotonos (ploo⬙rō-thŏt⬘ō-nŏs) [Gr.
pleurothen, from the side, ⫹ tonos,
plexus
top of rh
base of rh
tension] A tetanic spasm in which the
body is arched to one side.
pleurotomy (ploo-rŏt⬘ō-mē) [Gr. pleura,
side, ⫹ tome, incision] Incision of the
pleura.
pleurotyphoid (ploo⬙rō-tı̄⬘foyd) [⬙ ⫹ typhos, fever, ⫹ eidos, form, shape] Typhoid fever with pleural involvement.
plexal (plĕk⬘săl) [L. plexus, a braid]
Pert. to, or of the nature of, a plexus.
plexectomy (plĕk-sĕk⬘tō-mē) [⬙ ⫹ Gr.
ektome, excision] Surgical removal of a
plexus.
plexiform (plĕk⬘sı̆-form) [⬙ ⫹ forma,
shape] Resembling a network or
plexus.
pleximeter (plĕks-ı̆m⬘ĕ-tĕr) [Gr. plexis,
stroke, ⫹ metron, measure] A device
for receiving the blow of the percussion
hammer, consisting of a disk that is
struck in mediate percussion while being held over the surface of the body.
SYN: plessimeter; plexometer.
plexitis (plĕk-sı̄⬘tı̆s) [L. plexus, a braid,
⫹ Gr. itis, inflammation] Inflammation of a nerve plexus.
plexometer (plĕk-sŏm⬘ĕ-tĕr) Pleximeter.
plexopathy (plĕks-ŏp⬘ă-thē) A peripheral neuropathy. Any disease of a (peripheral) nerve plexus.
idiopathic brachial p. A peripheral
neuropathy that affects movement and
sensation in the shoulder. Idiopathic
brachial plexopathy usually results
from brachial nerve entrapment by vigorous exercise. It may cause atrophy of
the muscles surrounding the shoulder
(the “shoulder girdle”). Nonidiopathic
(i.e., readily identifiable) causes of the
neuropathy sometimes are found in persons with brachial nerve injury caused
by tumors or radiation. SYN: neuralgic
amyotrophy; Parsonage-Turner syndrome; shoulder girdle syndrome.
plexor (plĕks⬘or) A hammer or other device for striking on the pleximeter in
percussion. SYN: plessor.
plexus (plĕks⬘ŭs) pl. plexus, plexuses
[L., a braid] A network of nerves or of
blood or lymphatic vessels. SEE: rete.
Auerbach’s p. SEE: Auerbach’s
plexus.
autonomic p. An extensive network
of nerve fibers and neuron cell bodies
belonging to the sympathetic or parasympathetic nervous system.
brachial p. A network of the anterior
branches of the last four cervical and
the first thoracic spinal nerves supplying the arm, forearm, and hand.
cardiac p. Plexus cardiacus; the
nerve plexus at the base of the heart
made up of branches of the vagus nerves
and sympathetic trunks. Afferent
nerves from this plexus provide the
nerve supply to the heart.
cavernous p. The vascular plexus of
a cavernous part of the body. The follow-
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
plexus
-ploid
top of rh
base of rh
from the stomach to the internal anal
sphincter.
pliability (plı̄⬙ă-bı̆l⬘ı̆-tē) [O.Fr. pliant,
bend, ⫹ L. abilis, able] Capacity of
being bent or twisted easily.
plica (plı̄⬘kă) pl. plicae [L.] A fold. SEE:
fold.
circular p. One of the transverse
folds of the mucosa and submucosa of
the small intestine. Collectively they resemble accordion pleats, do not disappear with distention of the intestine,
and increase the surface area for absorption. SYN: circular fold.
lacrimal p. A mucosal fold at the
lower orifice of the nasolacrimal duct.
semilunar p. of the colon The transverse fold of mucosa of the large intestine lying between sacculations.
semilunar p. of the conjunctiva The
mucosal fold at the inner canthus of the
eye.
transverse p. of the rectum One of
the mucosal folds in the rectum.
plicate (plı̄⬘kāt) [L. plicatus] Braided or
folded.
plication (plı̄-kā⬘shŭn) [L. plicare, to
fold] The stitching of folds or tucks in
tissue at an organ’s walls to reduce its
size.
p. of the stomach A surgical procedure for obesity supplanted by partial
gastric bypass. SEE: fundoplication.
plicotomy (plı̄-kŏt⬘ō-mē) [⬙ ⫹ Gr. tome,
incision] Section of the posterior fold of
the tympanic membrane.
pliers (plı̄⬘ĕrz) 1. Commonly, a scissoraction, pointed-jawed tool for bending or
cutting metal wires or grasping small
objects. 2. In dentistry, a variety of instruments that have been shaped or
adapted for special uses such as cutting
arch wires or metal clasps, shaping
metal crown details, applying cotton
pledgets or rolls, carrying metal foils,
tying ligatures, and placing or removing
matrix bands.
plinth (plı̆nth) [Gr. plinthos, tile] A table, seat, or apparatus on which a patient lies or sits while doing remedial
exercise.
PLISSIT model (plı̆⬘sı̆t) A guideline used
to assess and manage sensitive psychosocial issues, among them issues relating to adult sexuality. The PLISSIT
method consists of four steps.
1. The practitioner obtains Permission to begin a discussion about sensitive issues.
2. Limited Information is provided to
the patient.
3. As trust is gained and the patient
becomes receptive, Specific Suggestions
are made.
4. Intensive Therapy is offered to
those who may require referral to a specialist.
-ploid [Gr. ploos, fold] Combining form
used as a suffix indicating the number
short
standard
1808
ing are included: Of the nose: a venous
plexus in the mucosa covering the superior and middle conchae. Of the penis:
a nerve plexus at the base of the penis
giving rise to large and small cavernous
nerves. Of the clitoris: nerve plexus at
the base of the clitoris, formed of fibers
from the uterovaginal plexus. Of the
cavernous sinus: a sympathetic plexus
that supplies fibers to the internal carotid artery and its branches within the
cranium.
celiac p. A sympathetic plexus lying
near the origin of the celiac artery.
cervical p. A network formed by the
first four cervical spinal nerves. It innervates parts of the face, neck, shoulder, and chest, and gives rise to the
phrenic nerve to the diaphragm.
choroid p. A capillary network located in each of the four ventricles of the
brain (two lateral, the third, and the
fourth) that produces cerebrospinal
fluid by filtration and secretion.
dental p. A network of sensory nerve
fibers that are distributed to the teeth.
The inferior alveolar nerve is distributed to the mandibular teeth; the anterior, middle, and posterior superior alveolar nerves contribute fibers to
innervate the maxillary teeth.
enteric p. One of two plexuses of
nerve fibers and ganglion cells that lie
in the wall of the alimentary canal.
These are the myenteric (Auerbach’s)
and submucosal (Meissner’s) plexuses.
lumbar p. A nerve plexus formed by
the ventral branches of the first four
lumbar nerves.
lumbosacral p. The lumbar plexus
and sacral plexus, considered as one.
myenteric p. Auerbach’s plexus.
nerve p. Plexus made of nerve fibers.
pampiniform p. In the male, a complicated network of veins lying in the
spermatic cord and draining the testis.
In the female, a network of veins lying
in the mesovarium and draining the
ovary.
prevertebral p. One of three plexuses
of autonomic nerve division that lie in
body cavities. These are the cardiac, celiac, and hypogastric (pelvic) plexuses.
prostatic p. 1. The veins around the
base and neck of the bladder and prostate gland. 2. The nerves from the pelvic plexus to the prostate gland, erectile
tissue of the penis, and the seminal vesicles.
sacral p. A nerve plexus formed by
the ventral branches of the fourth and
fifth lumbar nerves and the first four sacral nerves, from which the sciatic nerve
originates.
submucous p. A ganglionated neural network of the enteric nervous system. It is a collection of small connected
neural ganglia found in the gut wall
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
ploidy
1809
of chromosome pairs of the root word to
which it is added.
ploidy (ploy⬘dē) [Gr. ploos, a fold, ⫹ eidos, form, shape] The number of chromosome sets in a cell (e.g., haploidy, diploidy, and triploidy for one, two, and
three sets, respectively, of chromosomes).
plombage (plŏm-băzh⬘) [Fr. plomber, to
plug] A method of collapsing the apex
of the lung by stripping the parietal
pleura from the chest wall at the site of
desired collapse and packing the space
between the lung and the chest wall
with an inert substance such as small
balls made of certain plastic materials.
It is infrequent in current practice.
plototoxin (plō⬙tō-tŏk⬘sı̆n) A toxic substance present in catfish, Plotosus lineatus.
plug (plŭg) [MD. plugge] 1. A mass obstructing a hole or intended to close a
hole. 2. A plastic or metallic device for
closing the end of an instrument or tube.
epithelial p. A mass of epithelial cells
temporarily plugging an orifice in the
embryo, esp. the nasal openings.
mucous p. A mass of cells and mucus
that closes the cervical canal of the
uterus during pregnancy and between
menstrual periods.
vaginal p. A closed tube for maintaining patency of the vagina following
operation for fistula.
plugger A hand- or machine-operated device for condensing amalgam, or gold
foil, in the cavity preparation of a tooth.
automatic p. A plugger that is run by
a machine rather than by hand.
back-action p. A plugger with a bent
shank so that the pressure applied is
back toward the operator.
foot p. A plugger having a broad,
foot-shaped tip.
plumbic (plŭm⬘bı̆k) [L. plumbicus,
leaden] Pert. to, or containing, lead.
plumbism (plŭm⬘bı̆zm) [L. plumbum,
lead, ⫹ Gr. −ismos, condition] Poisoning from lead.
plumbum (plŭm⬘bŭm) [L.] Lead; a bluish-white metal. SEE: lead.
plume (ploom) A wisp or puff of smoke,
esp. one that may rise from a surgical
field in which electrocautery or lasers
are used to cut, coagulate, or destroy tissue. Surgical plumes may contain carbon monoxide, among other potentially
toxic gases.
Plummer-Vinson syndrome (plŭm⬘ĕrvı̆n⬘sŏn) [Henry S. Plummer, U.S. physician, 1874– 1937; Porter P. Vinson,
U.S. surgeon, 1890– 1959] Iron-deficiency anemia, associated with dysphagia, gastric achlorhydria, splenomegaly,
and spooning of the nails due to an
esophageal web. It occurs most commonly in premenopausal women. Treatment consists of disrupting the web.
SEE: esophageal web.
pneo-
top of rh
base of rh
plumper (plŭm⬘pĕr) [Middle Low Ger.
plump, to fill] A pad for filling out
sunken cheeks, sometimes in the form
of a flange or extension from artificial
dentures.
pluri- [L. plus, more] Prefix meaning several, more.
pluriceptor (ploo⬙rı̆-sĕp⬘tor) [L. plus,
more, ⫹ ceptor, a receiver] A receptor
that has more than two groups uniting
with the complement.
pluriglandular (ploo⬙rı̆-glănd⬘ū-lăr) [⬙ ⫹
glandula, gland] Polyglandular.
plurigravida (ploo⬙rı̆-grăv⬘ı̆-dă) [⬙ ⫹
gravida, pregnant] A pregnant woman
who has had three or more pregnancies.
plurilocular (ploo⬙rı̆-lŏk⬘ū-lăr) [⬙ ⫹ loculus, a cell] Multilocular.
plurinuclear (ploor⬙ı̆-nū⬘klē-ăr) [⬙ ⫹
nucleus, kernel] Having a number of
nuclei.
pluripara (ploo-rı̆p⬘ă-ră) [⬙ ⫹ parere, to
bring forth, to bear] A woman who has
given birth three or more times.
pluriparity (ploo⬙rı̆-păr⬘ı̆-tē) The condition of having three or more pregnancies that have reached a point of viability regardless of the outcome.
pluripotent, pluripotential (ploo-rı̆p⬘ōtĕnt, ploor⬙ı̆-pō-tĕn⬘shăl) [⬙ ⫹ potentia, power] 1. Concerning an embryonic
cell that can form different kinds of
cells. 2. Having a number of different
actions.
pluriresistant (ploor⬙ı̆-rē-zı̆s⬘tănt) [⬙ ⫹
resistens, standing back] Resistant to
several drugs, esp. antibiotics.
plutonium (ploo-tō⬘nē-ŭm) [Named after
the planet Pluto] SYMB: Pu. A radioactive element obtained from neptunium, which in turn is obtained from
uranium; atomic weight of the most stable isotope is 244; atomic number 94.
PLWA people living with HIV/AIDS.
plyometrics (plı̄-ō-mĕt⬘rı̆ks) A stretching and shortening exercise technique
that combines strength with speed to
achieve maximum power in functional
movements. This regimen combines eccentric training of muscles with concentric contraction.
Pm Symbol for the element promethium.
PMDD premenstrual dysphoric disorder.
PML progressive multifocal leukoencephalopathy.
PMS premenstrual syndrome.
PMSG pregnant mare serum gonadotropin. SEE: gonadotropin, human chorionic.
PMT photomultiplier tube; premenstrual
tension.
Pmus The pressure generated by the respiratory muscles during inspiration or
expiration.
PNA peptide nucleic acid
PNC premature nodal contraction or complex.
-pnea SEE: pneo-.
pneo-, -pnea (nē⬘ō) [Gr. pnein, to
short
standard
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pneum-
Pneumocystis jiroveci
top of rh
base of rh
from the breath exhaled through the
nostrils with the mouth closed for purpose of comparing the airflow through
the nostrils.
pneumectomy
(nū-mĕk⬘tō-mē)
[Gr.
pneumon, lung, ⫹ ektome, excision]
Excision of all or part of a lung.
pneumo-, pneumono- [Gr. pneumon,
lung] Combining form meaning air,
lung.
pneumoarthrography
(nū⬙mō-ărthrŏg⬘ră-fē) [⬙ ⫹ arthron, joint, ⫹
graphein, to write] Pneumarthrography.
pneumobilia (nū⬙mō-bı̆ll⬘ē-ah) Air or gas
within the biliary ducts, a finding associated primarily with cholecystitis that
is caused by gas-forming organisms.
pneumobulbar (nū⬙mō-bŭl⬘băr) [⬙ ⫹ L.
bulbus, bulbous root] Concerning the
lungs and respiratory center in the medulla oblongata of the brain.
pneumocentesis (nū⬙mō-sĕn-tē⬘sı̆s) [⬙
⫹ kentesis, a piercing] Paracentesis or
surgical puncture of a lung to evacuate
a cavity. SYN: pneumonocentesis.
pneumocephalus (nū⬙mō-sĕf⬘ă-lŭs) [Gr.
pneuma, air, ⫹ kephale, head] Intracranial pneumatocele.
pneumocholecystitis
(nū⬙mō-kō⬙lē-sı̆stı̄⬘tı̆s) [⬙ ⫹ chole, bile, ⫹ kystis, bladder, ⫹ itis, inflammation] Cholecystitis with gas in the gallbladder.
pneumococcal (nū⬙mō-kŏk⬘ăl) [⬙ ⫹
kokkos, berry] Concerning or caused by
pneumococci.
pneumococcemia (nū⬙mō-kŏk-sē⬘mē-ă)
The presence of pneumococci in the blood.
pneumococcidal (nū⬙mō-kŏk-sı̄⬘dăl) [⬙
⫹ ⬙ ⫹ L. cidus, killing] Killing pneumococci.
pneumococcolysis (nū⬙mō-kŏk-ŏl⬘ı̆-sı̆s)
[⬙ ⫹ kokkos, berry, ⫹ lysis, dissolution] Destruction or lysis of pneumococci.
pneumococcus (nū⬙mō-kŏk⬘ŭs) pl. pneumococci [⬙ ⫹ kokkos, berry] Streptococcus pneumoniae.
pneumocolon (nū⬙mō-kō⬘lŏn) [⬙ ⫹ kolon, colon] Air in the colon. This may be
introduced as an aid in radiological diagnosis.
pneumoconiosis (nū⬙mō-kō⬙nē-ō⬘sı̆s) [⬙
⫹ konis, dust, ⫹ osis, condition] Any
disease of the respiratory tract owing to
inhalation of dust particles; an occupational disorder such as that caused by
mining or stonecutting. SYN: pneumonoconiosis. SEE: table.
pneumocranium (nū⬙mō-krā⬘nē-ŭm) [⬙
⫹ kranion, skull] Intracranial pneumatocele.
Pneumocystis carinii (nū⬙mō-sı̆s⬘tı̆s kărı̄⬘nē-ı̄ ) SEE: Pneumocystis jiroveci.
Pneumocystis jiroveci (jı̆r-ō⬘vĕ-sı̄, sē,
chē) An opportunistic fungus that
causes lung infections in those with immunosuppressive diseases and condi-
short
standard
1810
breathe] Combining forms meaning
breath, breathing. SEE: pneumo-.
pneum-, pneuma-, pneumato- [Gr.
pneuma, pneumatos, air, breath] Combining form meaning air, gas, respiration.
pneumarthrogram (nū-măr⬘thrō-grăm)
[Gr. pneuma, air, ⫹ arthron, joint, ⫹
gramma, something written] A radiograph of a synovial joint after injection
of a radiolucent contrast medium, usually air; an obsolete technique.
pneumarthrography (nū⬙măr-thrŏg⬘răfē) [⬙ ⫹ ⬙ ⫹ graphein, to write] Radiography of a synovial joint after injection of a radiolucent contrast medium,
usually air. SYN: pneumoarthrography.
pneumarthrosis (nū-măr-thrō⬘sı̆s) [⬙ ⫹
⬙ ⫹ osis, condition] Accumulation of
gas or air in a joint.
pneumatic (nū-măt⬘ı̆k) [Gr. pneumatikos, pert. to air] 1. Concerning gas or
air. 2. Relating to respiration. 3. Relating to rarefied or compressed air.
pneumatic antishock garment ABBR:
PASG. Antishock garment.
pneumatics (nū-măt⬘ı̆ks) The branch of
physics that is concerned with the physical and mechanical properties of gases
and air.
pneumatization (nū⬙mă-tı̄-zā⬘shŭn) The
formation of air-filled cavities, usually
in bone (e.g., the paranasal sinuses and
mastoid sinuses).
pneumatized (noo⬘mŭ-tı̄zd, nū⬘) [⬙]
Filled with air or gas.
pneumatocardia (nū⬙măt-ō-kăr⬘dē-ă) [⬙
⫹ kardia, heart] Air or gas in the
heart chambers.
pneumatocele (nū-măt⬘ō-sēl) [⬙ ⫹ kele,
tumor, swelling] 1. A hernia of the lung
tissue. 2. A swelling containing gas or
air, esp. a swelling of the scrotum. SYN:
pneumonocele.
extracranial p. A collection of gas under the scalp, caused by a fracture of the
skull that communicates with a paranasal sinus.
intracranial p. A collection of gas
within the skull. SYN: pneumocephalus;
pneumocranium.
pneumatology (nū⬙mă-tŏl⬘ō-jē) [⬙ ⫹ logos, word, reason] The science of gases
and air and their chemical properties
and use in treatment.
pneumatosis (nū⬙mă-tō⬘sı̆s) [Gr. pneumatosis] The presence of air or gas in
an abnormal location in the body.
p. cystoides intestinalis The presence of thin-walled gas-filled cysts in
the intestines. The cause is unknown.
The cysts usually disappear but occasionally rupture and cause pneumoperitoneum.
pneumaturia
(noo⬙mă-toor⬘ē-ă)
[Gr.
pneuma, air, ⫹ ouron, urine] Excretion of urine containing free gas.
pneumatype (nū⬘mă-tı̄p) [⬙ ⫹ typos,
type] The deposit of moisture on glass
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pneumocystography
1811
The Pneumoconioses
Asbestosis
Black lung disease (coal worker’s
pneumoconiosis)
Mixed dust pneumoconiosis
Silicosis
Talcosis
*
*Asbestosis is currently the most common
lung disease caused by the inhalation of mineral dusts
tions. It was formerly called pneumocystis carinii. SEE: illus.
pneumocystography (nū⬙mō-sı̆s-tŏg⬘răfē) [Gr. pneuma, air, ⫹ kystis, bladder, ⫹ graphein, to write] A cystogram done after air has been introduced
into the urinary bladder.
pneumocystosis
(nū⬙mō-sı̆s-tō⬘sı̆s)
Pneumocystis carinii pneumonia.
pneumocyte (nū⬘mō-sı̄t) Either of the
two types of cells that form the alveoli
of the lung. Type I cells are simple squamous epithelium that permit gas exchange. Type II cells are rounded and
produce surfactant.
pneumoderma (nū⬙mō-dĕr⬘mă) [⬙ ⫹
derma, skin] Subcutaneous emphysema.
pneumodynamics (nū⬙mō-dı̄-năm⬘ı̆ks) [⬙
⫹ dynamis, force] The branch of science dealing with force employed in respiration.
pneumoempyema (nū⬙mō-ĕm-pı̄-ē⬘mă)
[⬙ ⫹ en, in ⫹ pyon, pus] Empyema
accompanied by an accumulation of gas.
pneumoencephalitis
(nū⬙mō-ĕn-sĕf⬙ălı̄⬘tı̆s) [⬙ ⫹ enkephalos, brain, ⫹ itis,
inflammation] Newcastle disease.
pneumoencephalography (nū⬙mō-ĕn-sĕf
⬙ă-lŏg⬘ră-fē) [⬙ ⫹ ⬙ ⫹ graphein, to
write] An obsolete term for radiography of the ventricles and subarachnoid
spaces of the brain following withdrawal of cerebrospinal fluid and injection of air or gas via lumbar puncture.
This technique has been replaced by
computed tomography and magnetic
resonance imaging.
pneumogalactocele
(nū⬙mō-găl-ăk⬘tōsēl) [⬙ ⫹ gala, milk, ⫹ kele, tumor,
swelling] A breast tumor containing
milk and gas.
pneumogastrography
(nū⬙mō-găstrŏg⬘ră-fē) [Gr. pneuma, air, ⫹ gaster,
stomach, ⫹ graphein, to write] A radiographical study of the stomach after
air has been introduced into it.
pneumogram
(nū⬘mō-grăm)
[⬙
⫹
gramma, something written] 1. A
record of respiratory movements. 2. A
radiograph following injection of air.
pneumograph
(nū⬘mō-grăf)
[⬙
⫹
graphein, to write] A device for recording the frequency and intensity of respiration.
pneumography (nū-mŏg⬘ră-fē) 1. An an-
pneumomediastinum
top of rh
base of rh
atomical description or illustration of
the lung. 2. The recording of respiratory
movements on a graph. 3. Radiography
of a part or organ after injection of air.
pneumohemopericardium
(nū⬙mōhēm⬙ō-pĕr-ı̆-kăr⬘dē-ŭm) [Gr. pneumon,
lung, ⫹ haima, blood, ⫹ peri,
around, ⫹ kardia, heart] The accumulation of air and blood in the pericardium.
pneumohemothorax
(nū⬙mō-hēm⬙ōthō⬘răks) [⬙ ⫹ ⬙ ⫹ thorax, chest]
Gas or air and blood collected in the
pleural cavity.
pneumohydrometra
(nū⬙mō-hı̄⬙drōmē⬘tră) [⬙ ⫹ hydor, water, ⫹ metra,
uterus] The accumulation of gas and
fluid in the uterus.
pneumohydropericardium
(nū⬙mōhı̄⬙drō-pĕr-ı̆-kăr⬘dē-ŭm) [⬙ ⫹ hydor,
water, ⫹ peri, around, ⫹ kardia,
heart] Air and fluid accumulated in the
pericardium.
pneumohydrothorax
(nū⬙mō-hı̄⬙drōthō⬘răks) [⬙ ⫹ ⬙ ⫹ thorax, chest]
Gas or air and fluid in the pleural cavity.
pneumohypoderma
(nū⬙mō-hı̄⬙pōdĕr⬘mă) [⬙ ⫹ hypo, under, ⫹ derma,
skin] Subcutaneous emphysema.
pneumolith (nū⬘mō-lı̆th) [⬙ ⫹ lithos,
stone] A pulmonary stone.
pneumolithiasis (nū⬙mō-lı̆th-ı̄⬘ăs-ı̆s) [⬙
⫹ ⬙ ⫹ −iasis, condition] Formation of
stones in the lungs.
pneumolysin (nū-mŏl⬘ı̆-sı̆n) A hemolytic
toxin produced by pneumococci.
pneumomalacia (nū⬙mō-mă-lā⬘shē-ă) [⬙
⫹ malakia, a softening] Abnormal
softening of the lung.
pneumomassage
(nū⬙mō-mă-săzh⬘)
[Gr. pneuma, air, ⫹ massein, to knead]
Massage of the tympanum with air to
cause movement of the ossicles of the inner ear.
pneumomediastinum (nū⬙mō-mē⬙dē-ăstı̄⬘nŭm) [⬙ ⫹ L. mediastinum, in the
middle] The presence of air or gas in
the mediastinal tissues, either owing to
disease or following injection of air into
the area. It is a cause of intense chest
pain that worsens with movement.
PNEUMOCYSTIS JIROVECI (⫻1000)
Silver-stained cysts in lung tissue (⫻400)
short
standard
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pneumomelanosis
1812
pneumomelanosis (nū⬙mō-mĕl-ăn-ō⬘sı̆s)
[Gr. pneumon, lung, ⫹ melano, black,
⫹ osis, condition] Pigmentation of the
lung seen in pneumoconiosis. SYN:
pneumonomelanosis.
pneumometer
(nū-mŏm⬘ĕt-ĕr)
[Gr.
pneuma, air, ⫹ metron, measure] Spirometer.
pneumomycosis (nū⬙mō-mı̄-kō⬘sı̆s) [Gr.
pneumon, lung, ⫹ mykes, fungus, ⫹
osis, condition] A fungal pulmonary
disease. SYN: pneumonomycosis.
pneumomyelography (nū⬙mō-mı̄-ĕl-g⬘răfē) [Gr. pneuma, air ⫹ myelos, marrow, ⫹ graphein, to write] An obsolete term for a radiographical study of
the spinal canal following injection of
air or other gas.
pneumonectomy
(nū⬙mŏn-ĕk⬘tō-mē)
[Gr. pneumon, lung, ⫹ ektome, excision] Pneumectomy.
pneumonia (nū-mō⬘nē-ă) [Gr.] Inflammation of the lungs, usually due to infection with bacteria, viruses, or other
pathogenic organisms. Clinically, the
term “pneumonia” is used to indicate an
infectious disease. Pulmonary inflammation due to other causes is generally
called “pneumonitis.” In the U.S., about
4,500,000 persons contract pneumonia
each year. The disease is the sixth most
common cause of death in the U.S. and
the most common cause of death due to
infectious disease. Pneumonia occurs
most commonly in weakened individuals, such as those with cancer, heart or
lung disease, immunosuppressive illnesses, diabetes mellitus, cirrhosis,
malnutrition, and renal failure, but virulent pathogens can cause pneumonia
in healthy persons as well. Smoking,
general anesthesia, and endotracheal
intubation each increase the risk for developing pneumonia by inhibiting airway defenses and helping disease-causing germs reach the alveoli of the lungs.
SEE: aspiration; pleural effusion; empyema; pleurisy; pneumonitis; tuberculosis (and names of lung pathogens);
Nursing Diagnoses Appendix.
ETIOLOGY: Pneumonias are categorized by site and by causative agent. Lobar pneumonia affects most of a single
lobe;
bronchopneumonia
involves
smaller lung areas in several lobes; interstitial pneumonia affects tissues surrounding the alveoli and bronchi of the
lung. Atypical pneumonias diffusely affect lung tissues rather than anatomical
lobes or lobules. Community-acquired
pneumonia is a lung infection that occurs in noninstitutionalized people, typically involving organisms such as viruses, Streptococcus pneumophila,
Klebsiella pneumoniae, Mycoplasma
pneumoniae, Legionella pneumophila,
Chlamydia pneumoniae, Moraxella species, or Pneumocystis carinii. Nosocomial pneumonia develops in patients in
pneumonia
top of rh
base of rh
the hospital or nursing home; this type
is most likely to be caused by gram-negative rods or staphylococcal species. Aspiration pneumonias result from the
inhalation of oropharyngeal microorganisms and often involve anaerobic organisms. Pneumonias in immunocompromised patients sometimes are
caused by Pneumocystis jiroveci or by
fungal species such as Aspergillus. or
Candida. Some fungal pneumonias occur in specific geographical regions of
the U.S. For example, histoplasmosis is
common in the Ohio River Valley, and
coccidioidomycosis is found in the San
Joaquin River Valley of southern California. Viral pneumonias may be caused
by influenza, varicella-zoster, herpes, or
adenoviruses, among others.
SYMPTOMS: Most patients with
pneumonia have cough, shortness of
breath, and fever, although these symptoms are not universal. Bacterial pneumonias are marked by abrupt onset,
with high fevers, shaking chills, pleuritic chest pain, and prostration. Patients with atypical pneumonias usually
have lower temperatures and nonproductive coughs and appear less ill.
PREVENTION: Pneumococcal vaccine
effectively prevents many forms of
streptococcal pneumonia; this vaccine is
recommended for persons over age 65;
those with chronic respiratory, cardiac,
or neuromuscular diseases; and patients with diabetes mellitus or renal
failure, among others.
TREATMENT: Treatment is based on
the clinical presentation (e.g., community-acquired versus nosocomial), results of the Gram stain of sputum specimens, the radiographical appearance of
the pneumonia, the degree of respiratory impairment, and the results of cultures. Many patients hospitalized with
pneumonia require supplemental oxygen and analgesics (pain relievers). Initial antibiotic treatments for pneumonia should be given without delay and
typically involve powerful, broad-spectrum drugs. The antibiotic used for subsequent therapy is guided by the results
of cultured specimens taken on presentation.
PATIENT CARE: A large percentage
of patients with pneumonia are not admitted to hospitals, but are treated with
antibiotics given on an outpatient basis.
However, older adults, people with serious chronic diseases, and those with
evidence of organ dysfunction, poor oxygenation, or acute decompensation
may need hospitalization to reduce the
risk of injury or death. Supportive care
is provided to the patient to remove secretions and improve gas exchange.
Such care includes position changes,
deep breathing and coughing exercises,
incentive spirometry, active and passive
short
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pneumonia
1813
limb exercises, and assistance with selfcare. Respiratory status is monitored by
listening to the chest for crackles and/or
wheezing, performing oximetry on a
regular basis, and, when patients are
failing, performing arterial blood gas
studies. Supplemental oxygen is usually
prescribed to maintain an oxygen saturation of ⬎ 92%. The patient is assessed
for signs and symptoms of respiratory
failure, sepsis, and shock. Mechanical
ventilation is required in patients with
respiratory failure. Analgesics are provided as prescribed to manage pain and
discomfort and encourage good pulmonary toilet. A large percentage of patients receive care to remove secretions
and to improve gas exchange. Such
care includes position changes, deepbreathing, and coughing exercises. The
patient is encouraged to verbalize concerns; diagnostic studies and therapeutic measures are explained, and the patient is taught about the importance of
follow-up care. Outpatient therapy of
community-acquired pneumonia can be
recommended for selected patients who
are young, otherwise healthy, and not
hypoxic, hypotensive, hypothermic, or
in renal failure. Activities are scheduled
to allow for plenty of rest. The patient is
taught hand hygiene, and encouraged to
wash hands with soap and water or use
an alcohol-based hand wipe entirely
over both hands after blowing the nose,
coughing, using the bathroom, or eating
or drinking. Only disposable tissues are
used for sneezing and coughing, used
tissues deposited in a lined bag taped to
the bedside, and these disposed of frequently according to agency policy. Unless otherwise restricted, the patient
should drink eight 12-ounce glasses of
water daily to help thin and loosen mucous secretions. Each patient’s meal
preferences and restrictions are discussed to plan a diet that ensures adequate high-caloric intake. Emotional
support is provided, and all procedures
and treatments are explained. The patient who smokes is taught the relationship between smoking and lung diseases (including the increased risk of
respiratory infections) and referred for
support group assistance with quitting
as needed. Pneumonia prevention is
aided by encouraging individuals to
avoid indiscriminate antibiotic use, get
pneumonia and influenza vaccinations,
perform deep-breathing and coughing
exercises when confined to bed and after
surgery, and ambulate early after surgery. Aspiration pneumonia is prevented in tube-fed patients by correct
positioning and slow, low volume feedings. Chronically ill and debilitated individuals in nursing homes should have
swallowing function assessed as necessary, with caregivers taught correct
pneumonia
feeding techniques to prevent aspiration.
abortive p. Mild pneumonia with a
brief course.
acute lobar p. Lobar pneumonia.
p. alba A pneumonia seen in stillborn infants; it is caused by congenital
syphilis.
aspiration p. Pneumonia caused by
inhalation of gastric contents, food, or
other substances. A frequent cause is
loss of the gag reflex in patients with
central nervous system depression or
damage or alcoholic intoxication with
stupor and vomiting. This condition also
occurs in newborns who inhale infected
amniotic fluid, meconium, or vaginal secretions during delivery.
atypical p. Pneumonia caused by a
virus or Mycoplasma pneumoniae. The
symptoms are low-grade fever, nonproductive cough, pharyngitis, myalgia,
and minimal adventitious lung sounds.
bacterial p. Pneumonia caused by
bacteria such as streptococcus, Staphylococcus aureus, Klebsiella, or coliforms.
chlamydial p. An atypical pneumonia caused by Chlamydia species, characterized clinically by cough, low-grade
fever, sore throat, and malaise. A chest
x-ray taken during the illness is more
likely to show diffuse lung involvement
than a lobar pneumonia.
community-acquired p. Pneumonia
occurring in outpatients, often caused
by infection with streptococcus, Haemophilus influenzae, Staphylococcus
aureus, and atypical organisms such as
Legionella species. Mortality is approximately 15% but depends on many host
and pathogen features.
desquamative interstitial p. Pneumonia of unknown cause, accompanied
by cellular infiltration or fibrosis in the
pulmonary interstitium. Progressive
dyspnea and a nonproductive cough are
symptoms characterizing this disease.
Clubbing of the fingers is a common
finding. Diffusion of oxygen and carbon
dioxide is abnormal. Diagnosis is made
by lung biopsy. The condition is treated
by corticosteroids.
double p. Pneumonia that involves
both lungs or two lobes.
embolic p. Pneumonia following embolization of a pulmonary blood vessel.
eosinophilic p. Infiltration of the
lung by eosinophils, typically found in
patients with peripheral eosinophilia.
The cause is usually unknown; occasionally, the condition responds to the administration of corticosteroids. In some
cases, a specific underlying cause is
found, such as the recent initiation of
cigarette smoking or an allergic drug reaction. Infection with some parasites or
fungi also can trigger the disease. SYN:
pulmonary infiltration with eosinophilia; PIE syndrome.
top of rh
base of rh
short
standard
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pneumonia
1814
pneumonia
top of rh
base of rh
LOBAR PNEUMONIA
(A) The right heart border is obscured by the infection, (B) Lateral view shows dense
(white) infiltrate sharply defined by horizontal fissure (Courtesy of Harvey Hatch, MD,
Curry General Hospital)
fibrous p. Pneumonia followed by
formation of scar tissue.
Legionella p. Legionnaires’ disease.
lipoid p. Damage to lung tissue that
Friedländer’s p. SEE: Friedländer’s
pneumonia.
gangrenous p. Pulmonary gangrene.
giant cell p. An interstitial pneumo-
results from aspiration of oils. It may occur repeatedly in patients with impaired swallowing mechanisms or in
persons affected by esophageal disorders, such as esophageal carcinoma,
achalasia, or scleroderma. Mineral oils
and cooking oils often are responsible.
Most cases resolve spontaneously, but
corticosteroids sometimes are used as
treatment to reduce inflammatory
changes. Distinguishing lipoid pneumonia from bacterial pneumonia may
require endoscopy.
lobar p. Pneumonia infecting one or
more lobes of the lung, usually caused
by Streptococcus pneumoniae. The pathologic changes are, in order, congestion;
redness and firmness due to exudate
and red blood cells in the alveoli; and,
finally, gray hepatization as the exudate
degenerates and is absorbed. SYN:
acute lobar p. SEE: illus.
neonatal p. Lung infection occurring
in the first few days of life due to uterine
exposure to infectious microorganisms
or to infection during or immediately after birth. Common causes include viruses (e.g., herpes simplex) and bacteria
(e.g., group B streptococcus, Chlamydia,
Escherichia coli, Listeria).
nosocomial p. Pneumonia occurring
after 48 hours of confinement in a hospital, intensive care unit, or nursing
home. It is often the result of infection
with gram-negative pathogens or multiply drug-resistant bacteria.
pneumococcal p. The most common
form of pneumonia in the U.S., affecting
nitis of infancy and childhood. The lung
tissue contains multinucleated giant
cells. The disease often occurs in connection with measles.
hypostatic p. Pneumonia occurring
in elderly or bed-ridden patients who remain constantly in the same position.
Ventilation is greatest in dependent areas; remaining in one position causes
hypoventilation in many areas, causing
alveolar collapse (atelectasis) and creating a pulmonary environment that
supports the growth of bacteria or other
organisms. Development of this condition is prevented by having the patient
change positions and take deep breaths
to inflate peripheral alveoli.
PATIENT CARE: Prevention is the
most important factor, esp. in older and
immobile persons. Patients should be
moved and turned frequently at least
every 1 to 2 hr. The nurse and respiratory therapist should monitor respiratory status by frequently auscultating
for crackles, gurgles, and wheezes, and
encourage the patient to engage in active movement and to perform deepbreathing and coughing exercises
frequently and regularly. Incentive spirometry may prove useful in patients
who need added encouragement to deep
breathe periodically.
intrauterine p. Pneumonia contracted in utero.
short
standard
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pneumonia
1815
about half a million people each year. It
often begins with hard-shaking chills
and may be fatal, esp. in the elderly or
those with underlying diseases. It usually strikes smokers, people with underlying lung diseases, those recently infected with influenza or those with
sickle-cell anemia, chronic or heavy alcohol use, or cirrhosis.
SYMPTOMS: Fevers, body-shaking
chills, productive cough, pleurisy, prostration, and sweating.
TREATMENT: Penicillin may be used
when the pneumococcus is sensitive to
this agent, but the incidence of penicillin resistance in pneumococci is rapidly
growing. Third-generation cephalosporins, erythromycin, vancomycin, and linezolid, are alternative agents.
PATIENT CARE: Vaccination provides passive immunity against many
serotypes of pneumococcal pneumonia.
People over the age of 65 or individuals
with heart, lung, liver, kidney, or immunosuppressive diseases should be
immunized as should infants under the
age of two years.
Pneumocystis carinii p. ABBR: PCP.
A subacute opportunistic infection
marked by fever, nonproductive cough,
tachypnea, dyspnea, and hypoxemia. It
is caused by Pneumocystis carinii, the
former name of Pneumocystis jiroveci, an
organism formerly thought to be a protozoan but now generally accepted as a fungus. The disease is seen principally in
immunosuppressed patients, such as persons with the acquired immunodeficiency
syndrome (AIDS) or those who have received an organ transplant and immunosuppressant drugs. Without treatment,
the progressive respiratory failure that
the infection causes is ultimately fatal.
DIAGNOSIS: The disease should be
suspected in patients with human immunodeficiency virus infection or other
risk factors for the disease who present
with cough and shortness of breath.
Chest x-ray examination may reveal diffuse interstitial infiltrates, upper lobe
disease, spontaneous pneumothorax, or
cystic lung disease. The diagnosis is
confirmed with special stains of sputum,
bronchial washings, or lung biopsy specimens. SEE: illus.
TREATMENT: Oral trimethoprimsulfamethoxazole effectively protects
against PCP, and is also the drug of
choice for active infection. Other drugs
that are active against PCP include pentamidine, trimethoprim in combination
with dapsone, and atovaquone. Corticosteroids are used as adjunctive therapy when treating markedly hypoxic
patients (e.g., those who present with an
alveolar-arterial oxygen gradient of
more than 35 mm Hg). The introduction
of highly active antiretroviral drug cock-
pneumonitis
top of rh
base of rh
PNEUMOCYSTIS CARINII PNEUMONIA
Silver-stained cysts in lung tissue (⫻400)
tails for AIDS patients has markedly reduced the incidence of PCP.
secondary p. Pneumonia that occurs
in connection with a specific systemic
disease such as typhoid, diphtheria, or
plague.
tuberculous p. Pneumonia caused by
Mycobacterium tuberculosis. SEE: tuberculosis.
tularemic p. Pneumonia caused by
Francisella tularensis. It may be primary or associated with tularemia.
ventilator-associated p. In patients
receiving mechanical ventilation, a new
and persistent infiltrate seen on chest xray associated with fever, elevated or
depressed white blood cell counts, and
sputum that is either purulent or full of
disease-causing bacteria.
viral p. Any infections of the lower
respiratory tract (the lungs, bronchioles, and trachea) caused by viral species such as adenovirus, coronavirus,
herpesviruses, influenza viruses, and
respiratory syncytial viruses. Viral
pneumonias may range from mild respiratory infections (with nonproductive
cough and low-grade fevers) to lifethreatening and highly contagious illnesses (such as SARS). SEE: bronchitis;
bronchiolitis.
woolsorter’s p. Pulmonary anthrax.
pneumonic (nū-mŏn⬘ı̆k) [Gr. pneumon,
lung] Concerning the lungs or pneumonia.
pneumonitis (nū⬙mō-nı̄⬘tı̆s) [⬙ ⫹ itis,
inflammation] Inflammation of the
lung, usually due to hypersensitivity
(allergy), radiation exposure, aspiration, viral infection, or autoimmune illnesses, such as systemic lupus erythematosus.
hypersensitivity p. Immunologically
induced inflammation of the lungs of a
susceptible host caused by repeated inhalation of a variety of substances including organic dusts. Included are
molds and other fungi from sources such
as cheese, vegetables, mushrooms,
flour, mushroom compost, bark of trees,
detergents, and contaminated humidi-
short
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pneumonitis
pneumothorax
top of rh
base of rh
(nū⬙mō-pĕr-ı̆-tōnē⬘ŭm) [⬙ ⫹ peritonaion, peritoneum]
1. A condition in which air or gas collects in the peritoneal cavity. This may
occur catastrophically when internal organs rupture. 2. Air or gas that has been
injected into the peritoneal cavity to facilitate laparoscopy.
pneumoperitonitis
(nū⬙mō-pĕr-ı̆-tōnı̄⬘tı̆s) [⬙ ⫹ peritonaion, peritoneum,
⫹ itis, inflammation] Peritonitis with
gas accumulation. SYN: pneumonoperitonitis.
pneumopexy (nū⬘mō-pĕks⬙ē) [Gr. pneumon, lung, ⫹ pexis, fixation] Pneumonopexy.
pneumopleuritis (nū⬙mō-ploo-rı̄⬘tı̆s) [⬙
⫹ pleura, a side, ⫹ itis, inflammation] Inflammation of the lungs and
pleura.
pneumopyopericardium
(nū⬙mō-pı̄⬙ōpĕr-ı̆-kar⬘dē-ŭm) [⬙ ⫹ pyon, pus, ⫹
peri, around, ⫹ kardia, heart] Air,
gas, and pus collected in the pericardium.
pneumopyothorax (nū⬙mō-pı̄⬙ō-thō⬘răks)
[⬙ ⫹ ⬙ ⫹ thorax, chest] Air and pus
collected in the pleural cavity.
pneumoretroperitoneum (nū⬙mō-rĕt⬙rōpĕr⬙ı̆-tō-nē⬘ŭm) [⬙ ⫹ L. retro, backwards, ⫹ Gr. peritonaion, peritoneum]
Air or gas in the retroperitoneal space.
pneumorrhachis (nū⬙mō-rā⬘kı̆s) [Gr.
pneumon, lung, ⫹ rhachis, spine] The
abnormal finding of gas within the spinal canal, e.g., after trauma.
pneumorrhagia (nū⬙mō-rā⬘jē-ă) [Gr.
pneumon, lung, ⫹ rhegnynai, to burst
forth] Lung hemorrhage. SEE: hemoptysis.
pneumoserothorax
(nū⬙mō-sē-rōthō⬘răks) [Gr. pneuma, air, ⫹ L. serum, whey, ⫹ Gr. thorax, chest] Air
or gas and serum collected in the pleural
cavity.
pneumosilicosis
(nū⬙mō-sı̆l⬙ı̆-kō⬘sı̆s)
[Gr. pneumon, lung, ⫹ L. silex, flint,
⫹ Gr. osis, condition] Silicosis.
pneumotaxic (nū⬙mō-tăk⬘sı̆k) [⬙ ⫹
taxis, arrangement] Concerning the
regulation of breathing.
pneumothorax (nū-mō-thō⬘răks ) [⬙ ⫹
thorax, chest] A collection of air or gas
in the pleural cavity. The gas enters as
the result of a perforation through the
chest wall (e.g., due to traumatic or iatrogenic injury) or the pleura (e.g., from
the rupture of an emphysematous bleb
or superficial lung abscess). Some tall
slender young men and women suffer
repeated episodes of spontaneous pneumothorax. SEE: illus.; Nursing Diagnoses Appendix.
SYMPTOMS: The onset is sudden,
usually with a severe sharp pain in the
side of the chest, and dyspnea. The
physical signs are those of a distended
unilateral chest, increased resonance,
decrease in or absence of breath sounds,
short
standard
1816
fication systems. In the acute stage, patients may present with cough, fever,
chills, malaise, and shortness of breath.
In the subacute and chronic forms, the
onset of symptoms is gradual and prolonged. Treatment includes identifying
and avoiding causative agents.
mycoplasma p. A form of atypical
pneumonia caused by Mycoplasma
pneumoniae.
pneumococcal p. Pneumonia in
which the causative agent is pneumococci. SEE: Streptococcus pneumoniae.
pneumono- [Gr. pneumon, lung] SEE:
pneumo-.
pneumonocele (nū-mōn⬘ō-sēl) [⬙ ⫹
kele, tumor, swelling] Pneumatocele.
pneumonocentesis
(nū-mō⬙nō-sĕntē⬘sı̆s) [⬙ ⫹ kentesis, a piercing]
Pneumocentesis.
pneumonoconiosis
(noo⬙mă-nō-kō⬙nēō⬘sı̆s) [⬙ ⫹ konis, dust, ⫹ osis, condition] Pneumoconiosis.
pneumonocyte (nū-mō⬘nō-sı̄t) Either a
type I or a type II alveolar cell of the
lungs.
pneumonolysis (nū⬙mŏ-nŏl⬘ı̆-sı̆s) [⬙ ⫹
lysis, dissolution] The loosening and
separation of an adherent lung from the
costal pleura.
extrapleural p. Separation of the parietal pleura from the chest wall. SEE:
apicolysis.
intrapleural p. Separation of adhering visceral and parietal layers of
pleura.
pneumonomelanosis (nū⬙mō-nō-mĕl⬙ăn⬘sı̆s) [⬙ ⫹ melano, black, ⫹ osis, condition] Pneumomelanosis.
pneumonomycosis (nū-mōn⬙ō-mı̄-kō⬘sı̆s)
[⬙ ⫹ mykes, fungus, ⫹ osis, condition]
Pneumomycosis.
pneumonopathy (nū⬙mō-nŏp⬘ăth-ē) [⬙
⫹ pathos, disease, suffering] Any diseased condition of the lung.
pneumonoperitonitis
(nū⬙mō-nō-pĕr⬙ı̆tō-nı̄⬘tı̆s) [⬙ ⫹ peritonaion, peritoneum, ⫹ itis, inflammation] Pneumoperitonitis.
pneumonopleuritis
(nū-mō⬙nō-ploorı̄⬘tı̆s) [Gr. pneumon, lung, ⫹ pleura,
side, ⫹ itis, inflammation] Pneumopleuritis.
pneumonorrhapy (nū⬙mō-nor⬘ă-fē) [⬙ ⫹
rhaphe, seam, ridge] Suture of a lung.
pneumonotherapy
(noo-mŏn⬙ă-thĕr⬘ăpē, nū-) Pneumotherapy.
pneumonotomy (nū-mō-nŏt⬘ō-mē) [⬙ ⫹
tome, incision] Incision into the lung.
SYN: pneumotomy.
pneumopericardium
(nū⬙mō-pĕr-ı̆kăr⬘dē-ŭm) [Gr. pneuma, air, ⫹ peri,
around, ⫹ kardia, heart] Air or gas in
the pericardial sac; caused by trauma or
pathological communication between
the esophagus, stomach, or lungs and
the pericardium. On examination one
finds unusual metallic heart sounds and
tympany over the precordial area.
pneumoperitoneum
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1817
pneumothorax
pneumothorax
top of rh
base of rh
(CHEST WALL INJURY PERMITS
AIR TO FLOW IN AND OUT OF THE PLEURAL
SPACE ON THE AFFECTED SIDE)
TRACHEA AND MEDIASTINUM
SHIFTED AWAY FROM
PNEUMOTHORAX
TRAUMATIC
RUPTURE OF
THE CHEST WALL
AIR HAS ENTERED THE
PLEURAL SPACE AND
COLLAPSED THE LUNG
HEART AND VESSELS IN
THE MEDIASTINUM
NORMAL
PLEURAL
SPACE
PLEURAL SPACE
FILLED WITH AIR
INHALATION: AIR ENTERS THE INJURED
SIDE, CAUSING COLLAPSE OF THE LUNG
AND SHIFT OF THE MEDIASTINUM AND
HEART TOWARD THE UNAFFECTED SIDE
EXHALATION: THE AIR IS PARTIALLY
FORCED FROM THE AFFECTED SIDE
PLEURAL SPACE AND THE MEDIASTINUM
SHIFTS TOWARD THE AFFECTED SIDE
OPEN PNEUMOTHORAX
and, if fluid is present, a splashing
sound on succussion (or shaking) of the
patient. Patients often report chest pain
is worsened by coughing, deep
breathing, or movement.
DIAGNOSIS: Chest x-rays confirm
the diagnosis, revealing air in the
pleural space, often identified as a line
seen outlining a partially collapsed
lung. A shift of the mediastinum
toward one side of the chest or the
other may be seen in tension pneumothorax. SEE: tension p.
TREATMENT: Treatment varies according to type and amount of lung collapse. Traumatic or iatrogenic pneumothorax requires chest tube insertion
to closed (water-sealed) chest drainage
for lung re-expansion. Surgical repair
also may be required. Spontaneous
pneumothorax may be treated conservatively with bedrest if there is no sign of
increased pleural pressure, less than
15% lung collapse, no dyspnea or other
indication of physiological compromise.
If the patient’s condition worsens or if
more than 15% of the lung is collapsed,
a thoracostomy tube may be placed anteriorly in the second intercostal space
and attached to a Heimlich flutter valve
or chest-drainage unit. If fluid is present
in the pleural space, a thoracostomy
tube is placed in the fourth, fifth, or
sixth intercostal space more posteriorly
to drain it.
PATIENT CARE: The patient’s vital
signs, chest expansion, oximetry and/or
blood gases are monitored and oxygen
administered to prevent hypoxia. The
purpose and process for placing a chest
tube are explained to the patient to allay anxiety and foster cooperation with
the procedure. After the surgeon prepares and drapes the patient in sterile
fashion, and administers local anesthesia, a small incision is made. A thoracostomy tube is attached to a watersealed drainage device. The patient is
placed in the semi-Fowler position to
promote drainage, comfort, and ease of
breathing. Vital signs and ventilatory
status are monitored. Once the tube is
placed, deep breathing (incentive spirometry) and coughing are encouraged
(at least hourly) to promote lung expansion, with prescribed analgesics provided to control pain and discomfort
(due in part to the tube itself). Ambulation is encouraged to facilitate full inspiration and enhance lung expansion.
The thoracostomy tube site is kept
sealed, generally by using a pursestring suture and occlusive dressing.
Care is taken to avoid tension on the
tubing, and all connections also are
sealed to avoid air leaks. If the tube is
accidentally dislodged, an occlusive (petroleum gauze) dressing is placed over
the opening immediately to prevent
lung collapse. When chest x-ray demonstrates adequate lung re-expansion
that remains stable without suction, the
thoracostomy tube is carefully removed,
and the incision is covered with an occlusive dressing. The importance of follow-up examination, x-ray, and any
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pneumothorax
podiatry
top of rh
base of rh
pneumonia at onset. 2. The development of pneumonia during typhoid fever.
Pneumovax 23 (noo⬘mō-văks⬙) Pneumococcal vaccine, polyvalent.
pneumoventricle (nū⬙mō-vĕn⬘trı̆-k’l) [⬙
⫹ L. ventriculus, little belly] Air accumulation in the cerebral ventricles.
Po Symbol for the element polonium.
PO2 partial pressure of oxygen.
p.o. L. per os, by mouth.
pock (pŏk) [AS. poc, pustule] A pustule
of an eruptive fever, esp. of smallpox.
pocket (pŏk⬘ĕt) [ME. poket, pouch] A
saclike cavity.
gingival p. Periodontal pocket.
periodontal p. A pathologically deepened gingival sulcus enlarged beyond
normal limits as a result of the destructive effects of bacterial plaque; the space
bordered on one side by the tooth and
the other side by ulcerated sulcular epithelium. The pocket contains inflammatory cells and destructive enzymes
released by bacteria, and is surrounded
by diseased gum tissue. SYN: gingival p.
pocket reduction A surgical procedure to
eliminate deep periodontal spaces that
have formed around teeth. Periodontal
pockets are colonized and/or infected by
numerous disease-causing bacteria. The
periodontist peels away and surgically
removes infected gum tissue surrounding the tooth, smoothing uneven dental
surfaces and removing tartar before suturing healthy gum back onto the affected tooth.
pockmarked (pŏk-mărkd) Pitted or
marked with scars from healed pustules, esp. those due to smallpox.
podagra (pō-dăg⬘ră) [Gr. podos, foot, ⫹
agra, seizure] Gout, esp. of the joints of
the great toe.
podalgia (pō-dăl⬘jē-ă) [⬙ ⫹ algos, pain]
Pain in the feet.
podalic (pō-dăl⬘ı̆k) [Gr. podos, foot]
Pert. to the feet.
podcast A World Wide Web feed of audio
or video files for playing on mobile devices such as MP3 players at a later
time and at a listener’s or viewer’s convenience.
podencephalus (pŏd⬙ĕn-sĕf⬘ă-lŭs) [⬙ ⫹
enkephalos, brain] A deformed fetus in
whom most of the brain is outside the
skull and is attached by a thin pedicle.
podiatrist (pō-dı̄⬘ă-trı̆st⬙) [⬙ ⫹ iatreia,
treatment] A health professional responsible for the examination, diagnosis, prevention, treatment, and care of
conditions and functions of the human
foot. A podiatrist performs surgical procedures and prescribes corrective devices, drugs, and physical therapy as legally authorized in the state in which he
or she is practicing. SYN: chiropodist.
podiatry (pō-dı̄⬘ă-trē) The diagnosis,
treatment, and prevention of conditions
of human feet. SYN: chiropody.
short
standard
1818
needed care is explained prior to discharge. Patients who smoke are urged
to stop smoking and exercise is increased gradually as determined by follow-up evaluation.
artificial p. A pneumothorax induced
intentionally by artificial means, used
to treat pulmonary tuberculosis or
pneumonia. Pneumothorax allows the
diseased lung to rest temporarily. The
lung collapses when the air enters the
pleural space.
Scattered adhesions may afford only
a partial collapse. Effusion may occur in
about one third of the cases. Hazards include pain, infection, and respiratory
distress.
extrapleural p. The formation of a
pneumothorax by introducing air into
the space between the pleura and the
inside of the rib cage.
open p. A pneumothorax in which the
pleural cavity is exposed to the atmosphere through an open wound in the
chest wall.
spontaneous p. The spontaneous entrance of air into the pleural cavity. The
pressure may collapse the lung and displace the mediastinum away from the
side of the lesion.
SYMPTOMS: Although some patients
with pneumothorax have few symptoms, most people who come to clinical
attention report the sudden onset of
left- or right-sided chest pain, often accompanied by shortness of breath.
Breath sounds may be absent on the affected side, or the lung percussion note
on that side may reveal increased resonance.
tension p. A type of pneumothorax in
which air can enter the pleural space
but cannot escape via the route of entry.
This leads to increased pressure in the
pleural space, resulting in lung collapse.
The increase in pressure also compresses the heart and vena cavae, which
impairs circulation.
PATIENT CARE: The patient is assessed for evidence of respiratory failure or the need for immediate intervention. The development of tension
pneumothorax is a medical emergency;
if it is not promptly relieved, the patient
will experience inadequate cardiac output and hypoxemia (and may die). To
prevent rapid decompensation, a largebore needle is inserted emergently into
the pleural space at the second intercostal space, mid-clavicular line (needle decompression, needle thoracotomy). This
temporizing procedure must be followed
by thoracostomy tube placement and
water-sealed chest drainage unit.
pneumotomy (nū-mŏt⬘ō-mē) [Gr. pneumon, lung, ⫹ tome, incision] Pneumonotomy.
pneumotyphus (nū⬙mō-tı̄⬘fŭs) [⬙ ⫹ typhos, fever] 1. Typhoid fever with
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1819
podium
podium (pō⬘dē-ŭm) [Gr. podos, foot] A
footlike projection.
podo-, pod- [Gr. pous, podos, foot] Combining form meaning foot.
podobromidrosis (pŏd⬙ō-brō⬙mı̆-drō⬘sı̆s)
[⬙ ⫹ bromos, stench, ⫹ hidros, sweat]
Offensive perspiration of the feet.
podocyte (pŏd⬘ō-sı̄t) [⬙ ⫹ kytos, cell] A
special epithelial cell with numerous
footplates (pedicels). These form the inner layer of Bowman’s capsule of the renal corpuscle and have spaces for the
passage of renal filtrate from the glomerulus.
podosome (pŏd⬘ă-sōm⬙) [⬙ ⫹ Gr. soma,
body] A cellular structure composed of
actin and integrins that is used by mesenchymal cells to hold them to each
other or to neighboring cells. Podosomes
are found, e.g., on osteoclasts attached
to bone.
POEMS syndrome (pō⬘ ı̆mz) [Acronym
fr. polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes ] A rare multisystem disease characterized by
polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy,
and skin changes. It often presents with
osteosclerotic bone lesions associated
with plasma cell dyscrasia. The cause is
unknown. SYN: Crow-Fukase syndrome.
pogoniasis (pō⬙gō-nı̄⬘ă-sı̆s) [Gr. pogon,
beard, ⫹ −iasis, disorder] 1. Excessive
growth of the beard. 2. Growth of a
beard in a woman.
Pogosta disease (pō-gŏs⬘ tă) [Pogosta, a
town in Finland] An infectious disease
caused by Sindbis virus. Its primary
symptoms are fever, rash, and arthritis.
The disease is found primarily in northern European countries (e.g., Finland).
-poiesis [Gr.] Combining form used as a
suffix meaning formation, production.
poikilo- Combining form meaning irregular, varied.
poikilocyte (pŏy-kı̆l-ō-sı̄t) A teardrop or
pear-shaped red blood cell, seen in myelofibrosis and certain anemias. SEE: illus.
POIKILOCYTES (⫻640)
poikilocytosis (poy⬙kı̆l-ō-sı̄-tō⬘sı̆s) [⬙ ⫹
⬙ ⫹ osis, condition] A term used to de-
point
scribe variations in shape of red blood
cells (e.g., elliptocytes, spherocytes, dacryocytes, sickle cells, schizocytes, echinocytes, and acanthocytes).
poikilodentosis (poy⬙kı̆-lō-dĕn-tō⬘sı̆s) [⬙
⫹ L. dens, tooth, ⫹ Gr. osis, condition] Mottling of the teeth usually
caused by an excess of fluoride in the
drinking water.
poikiloderma (poy-kı̆l-ō-dĕr⬘mă) [⬙ ⫹
derma, skin] A skin disorder characterized by pigmentation, telangiectasia,
purpura, pruritus, and atrophy.
p. atrophicans vasculare A generalized dermatitis of unknown cause. It is
symmetrical and occurs almost exclusively in adults. There is widespread
telangiectasia, pigmentation, and atrophy of the skin.
p. of Civatte Reticulated pigmentation and telangiectasia of the sides of
the face and neck; seen quite commonly
in middle-aged women.
poikilonymy (poy⬙kı̆-lŏn⬘ı̆-mē) [⬙ ⫹ onoma, name] The use of terms from several nomenclature systems.
poikilotherm (poy-kı̆l⬘ō-thĕrm) [⬙ ⫹
therme, heat] Ectotherm.
poikilothermal
(poy⬙kı̆-lō-thĕr⬘măl)
Concerning poikilothermy.
poikilothermy (poy⬙kı̆-lō-thĕr⬘mē) The
condition of having the temperature of
the organism or animal match the temperature of the environment. Reptiles
have this property. SEE: ectotherm; endotherm.
poikilothrombocyte (poy-kı̆l⬙ō-thrŏm⬘bōsı̄t) [⬙ ⫹ thrombos, clot, ⫹ kytos, cell]
An abnormally shaped platelet.
point (poynt) [O.Fr., a prick, a dot]
1. The sharp end of any object. 2. The
stage at which the surface of an abscess
is about to rupture. 3. A minute spot.
4. A position in space, time, or degree.
absorbent p. A cone of paper used in
drying or in keeping liquid medicines in
a root canal of a tooth.
acupuncture p. Any anatomical location used in acupuncture to relieve
symptoms or treat disease.
auricular p. The center of the external orifice of the auditory canal.
boiling p. The temperature at which
a liquid boils. The boiling point of a liquid varies according to the chemicals
present in it. Under ordinary conditions
water boils at 212⬚F (100⬚C) at sea level.
To kill most vegetative forms of microorganisms, water should be boiled for 30
min.
Capuron’s p. One of four fixed points
in the pelvic inlet, the two iliopectineal
eminences and the two sacroiliac joints.
SYN: cardinal p. (2).
cardinal p. 1. One of six points determining the direction of light rays emerging from and entering the eye. SEE:
nodal p.; principal p. 2. Capuron’s point.
top of rh
base of rh
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point
1820
cold rigor p. The temperature at
which cell activity ceases.
contact p. The point on a tooth that
touches an opposed tooth.
convergence p. 1. The point to which
rays of light converge. 2. The closest
point to the patient on which the eyes
can converge as the object is moved
closer and closer.
corresponding p. The point in the
retina of each eye that, when stimulated
simultaneously, results in a single visual sensation.
craniometric p. One of the fixed
points of the skull used in craniometry.
SEE: craniometry for illus.
critical p. of gases The temperature
at or above which a gas is no longer liquefied by pressure.
critical p. of liquids The temperature
above which no pressure may retain a
substance in a liquid form.
deaf p. of the ear One of several
points or areas close to the external auditory meatus where a vibrating tuning
fork is not heard.
disparate p. Points on the retinas
that are unequally paired.
end p. The point or time at which a
reaction or activity is completed.
external orbital p. The prominent
point at the outer edge of the orbit above
the frontomalar suture.
far p. Point (normally 20 ft [6.1 m] or
more) at which distinct vision is possible
without aid of the muscles of accommodation. It may be nearer than 20 ft (6.1
m) according to the degree of myopia.
There is no far point in the hypermetropic eye.
fixation p. The fovea or point on the
retina where the visual axes (lines)
meet the point of clearest vision.
flash p. The temperature at which a
substance bursts into flame spontaneously.
focal p. The point at which a group
of light rays converge.
freezing p. The temperature at
which liquids become solid.
fusion p. Melting point.
Guéneau de Mussy’s p. The point located at the junction of a line extending
down from the left border of the sternum with a horizontal line at the level
of the bony part of the anterior portion
of the tenth rib. Pressure on this point
causes pain in cases of diaphragmatic
pleurisy.
gutta-percha p. A cone made of
gutta-percha combined with other material that is used in filling root canals
of teeth.
Halle’s p. [Adrien Joseph Marie Nöel
Halle, Fr. physician, 1859– 1947] The
point at the intersection of a horizontal
line drawn from the anterior superior iliac spines and an angled line extending
up from the pubic spine. At that point,
point
top of rh
base of rh
the ureter is palpable as it crosses the
pelvic brim.
hot p. A spot on the skin that perceives hot but not cold stimuli.
ice p. The temperature at which
there is equilibrium between ice and
air-saturated water at one atmosphere
of pressure.
identical retinal p. The points in the
two retinas upon which the images are
seen as one.
isoelectric p. The particular pH of a
solution of an amphoteric electrolyte
such as an amino acid or protein in
which the charged molecules do not migrate to either electrode. Proteins are
least soluble at this point. Thus at the
appropriate pH, proteins may be precipitated.
isoionic p. The pH at which a solution of ionized material has as many
negative as positive ions.
J p. On the electrocardiogram, the
juncture between the end of the QRS
complex and the beginning of the T
wave; that is, between the representations of ventricular depolarization and
repolarization.
lacrimal p. The outlet of the lacrimal
canaliculus. SYN: punctum lacrimale.
Lanz’s p. [Otto Lanz, Swiss surgeon
in the Netherlands, 1865– 1935] The
point on the line between the two anterior superior iliac spines, one third of
the distance from the right spine, indicating the origin of the vermiform appendix.
Lian’s p. The point at the junction of
the outer and middle thirds of a line
from the umbilicus to the anterior superior spine of the ilium where a trocar
may be introduced safely for paracentesis.
p. of maximal impulse ABBR: PMI.
The point on the chest wall over the
heart at which the contraction of the
heart is best seen or felt; normally at the
fifth intercostal space in the midclavicular line.
maximum occipital p. The point on
the occipital bone farthest from the glabella.
melting p. SEE: melting point.
mental p. The most anterior point of
the midline of the chin.
metopic p. Glabella.
motor p. The point usually about the
middle of a muscle where a motor nerve
enters the muscle at which a minimal
electrical stimulus to the overlying skin
will elicit a visible contraction.
Munro’s p. [John Cummings Munro,
U.S. surgeon, 1858– 1910] The point
halfway between the left anterior iliac
spine and the umbilicus.
nasal p. Nasion.
p. of no return A colloquial term describing a critical biochemical event
that indicates lethal, irreversible
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changes in cells following ischemic cell
injury.
nodal p. Either of a pair of points situated on the axis of an optical system so
that any incident ray sent through one
will produce a parallel emergent ray
sent through the other.
occipital p. The most posterior point
on the occipital bone.
pressure p. SEE: under pressure.
principal p. One of two points so situated that the optical axis is cut by the
two principal planes.
p. of regard The point at which the
eye is looking.
silver p. An elongated, tapered silver
plug used to fill the root canal in the endodontic treatment of teeth.
subnasal p. The center of the base of
the anterior nasal spine.
supra-auricular p. The point on the
skull on the posterior root of the zygomatic process of the temporal bone, directly above the auricular point.
supraorbital p. A neuralgic point just
above the supraorbital notch.
tender p. One of the anatomic locations used to identify fibromyalgia. The
deep diffuse muscular pain is localized
to a number of reproducible (from patient to patient) areas that are tender
when palpated. Tender points differ
from trigger points in that pain does not
radiate to referred areas. SEE: fibromyalgia for table.
thermal death p. The temperature
required to kill all of the organisms in a
culture in a specified time.
trigger p. SEE: under trigger.
triple p. The temperature and pressure that allow the solid, liquid, and vapor forms of a substance to exist in equilibrium.
vital p. The point in the medulla oblongata close to the floor of the fourth
ventricle, the puncture of which causes
instant death owing to destruction of
the respiratory center.
Voillemier’s p. The point on the linea
alba of the abdominal wall about 6 to 7
cm below a line connecting the anterior
superior iliac spines. Suprapubic puncture of the bladder may be made at this
point in obese or edematous individuals.
point of care Any location where patient
care is provided, including, e.g., the bedside, radiology suite, emergency room,
clinic, or ambulance.
point of entry In dental or medical radiography, the location on the face toward
which the central ray is directed. Points
of entry are typically in the region of the
apices of the teeth.
pointer, light A head-mounted input device to enable computer use by persons
with paralysis or limited movement.
These devices typically operate through
visible or invisible light sources at the
tip of the pointer, which transmits a sig-
poison
nal to a computer-mounted light sensor
or receiver.
pointillage (pwăn⬙tı̆-yăzh⬘) [Fr.] Massage with the fingertips. SEE: effleurage.
pointing 1. Reaching a point. 2. Forming
a localized collection of pus near the
body surface.
point-of-care testing ABBR: POCT. Use
of testing equipment in an area near the
patient, rather than sending the specimen to a laboratory. This enables health
care providers to learn the results of the
test immediately. Glucometers were the
first of many new devices that allowed
tests previously performed in the laboratory to be done in the clinical setting.
Examples of POCT are Nitrazine strips
for measuring vaginal pH, refractometers for measuring urine specific gravity, and immunoassays for measuring
the creatine phosphokinase isoenzymes,
myoglobin, and troponin I. As the number of these devices increases, regulatory agencies have recognized this
change in practice and have established
guidelines for case quality.
point of service A form of extended
health-care coverage granted to members of managed-care plans who opt to
pay additional premiums for medical
services provided by special panels of
providers.
poise (poyz) [J. M. Poiseuille] The unit
of viscosity; the tangential shearing
force required to be applied to an area
of 1 cm2 between two parallel planes of
1 cm2 in area and 1 cm apart in order to
produce a velocity of flow of the liquid of
1 cm/sec.
Poiseuille’s law (pwă-zŭ⬘yĕz) [Jean Marie Poiseuille, Fr. physiologist, 1799–
1869] A law that states that the rapidity of the capillary current is directly
proportional to the fourth power of the
radius of the capillary tube, the pressure on the fluid, and inversely proportional to the viscosity of the liquid and
the length of the tube.
Poiseuille’s space The sluggish current
close to the wall of a blood vessel where
blood cells move slowly, if at all; rapid
flow occurs down the middle of the vessel.
POISINDEX姟 (pŏy-zı̆n-dĕks) A computerized database, revised quarterly, on
over 300,000 commercial compounds.
For information, contact Micromedex,
Inc., 600 Grant St., Denver, CO 80203;
(800) 525-9083.
poison (poy⬘zn) [L. potio, a poisonous
draft] Any substance taken into the
body by ingestion, inhalation, injection,
or absorption that interferes with normal physiological functions. Virtually
any substance can be poisonous if consumed in sufficient quantity; therefore
the term poison more often implies an
excessive degree of dosage rather than
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1822
poison
a specific group of substances. Aspirin is
not usually thought of as a poison, but
overdoses of this drug kill more children
accidentally each year than any of the
traditional poisons. SEE: poisoning;
Poisons and Poisoning Appendix.
cellular p. Anything that damages or
kills cells.
p. ivy A climbing vine, Toxicodendron radicans, which on contact may
produce a severe form of pruritic dermatitis. Rhus species contain urushiol,
an extremely irritating oily resin, and
pentadecylcatechol, a common allergen,
which stimulates a type IV hypersensitivity reaction. First contact produces
sensitization; later contacts cause severe blistering, eczema, and itching.
SEE: illus. (Poison Ivy-Poison Oak-Poison Sumac; Poison Ivy Dermatitis).
POISON IVY, POISON OAK, POISON
SUMAC
(FROM TOP TO BOTTOM)
POISON IVY DERMATITIS
p. oak A climbing vine, Toxicodendron diversiloba, closely related to poison ivy and having the same active substances. SEE: poison ivy for illus.
poisoning
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pesticidal p. Chemicals whose toxic
properties are commercially exploited
in agriculture, industry, or commerce to
increase quantity, improve quality, or
generally promote consumer acceptability of a variety of products. Common
types include insecticides, rodenticides,
herbicides, defoliants, fungicides, insect
repellents, molluscicides, and some
kinds of food additives. The wide variety
of poisons commonly found in and
around the home constitutes an important source of accidental poisonings.
SEE: Poisons and Poisoning Appendix.
p. sumac SEE: under sumac.
poison control center A facility meeting
the staffing and equipment standards of
the American Association of Poison
Control Centers and recognized to be
able to give information on, or treatment to patients suffering from, poisoning. A poison information center consists of specially trained staff and a
reference library but does not have
treatment facilities. More than 400 poison centers are scattered throughout
the U.S. They offer 24-hr service. They
are commonly associated with or are
part of large hospitals or medical
schools. A government agency— the Bureau of Drugs Division of the Poison
Control Branch of the Food and Drug
Administration, U.S. Department of
Health and Human Services— is also
active in poison control programs and in
coordinating the efforts of individual
centers. For the address and telephone
number of state or province poison control centers, SEE: Health Care Resources Appendix.
poisoning [L. potio, a poisonous draft]
1. Illness produced by the introduction
of a toxic substance into the body. 2. Administration of a noxious substance.
SEE: intoxication; Poisons and Poisoning Appendix.
PATIENT CARE: Poisoning should be
suspected in many clinical circumstances but esp. in instances in which a
patient has otherwise unexplained alterations in consciousness. The standard care of the poisoned patient begins
with immediate stabilization of the patient’s airway, breathing, circulation,
and neurological status if these are compromised. This may require oximetry,
blood gas analysis, electrocardiographic
monitoring, airway placement, endotracheal intubation, fluid resuscitation, administration of naloxone and dextrose,
or the use of pressors for some severely
intoxicated patients. If the intoxicating
substance can be identified, reference
texts or local poison control centers
should be contacted to determine specific antidotes or treatments. When the
poison is not identified or when rescuers
are uncertain about the underlying
cause, it is safest to test blood and urine
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for acetaminophen, aspirin, and commonly abused drugs. Blood testing
should also include assessments of electrolytes, kidney function, liver function,
and a complete blood count. Women of
childbearing age should also be routinely screened for pregnancy.
Decontamination of the gastrointestinal tract may include the use of activated charcoal if the patient has ingested a drug or chemical to which the
charcoal can bind; or whole bowel irrigation, which sweeps toxins from the
bowel before they are absorbed. Inducing vomiting, formerly relied on in poisonings, is now rarely used because it
has not been shown to improve outcome
and may cause complications such as
aspiration pneumonia. After decontamination procedures specific antidotes, if
available, should be administered.
The elimination of many drugs from
the body can be enhanced by other
means, including, in some instances,
the administration of alkaline fluids,
hemodialysis, or hemoperfusion.
Once the patient is physically stabilized, the underlying reason for the intoxication should be addressed. Patients with substance abuse problems
should be referred for detoxification,
support, and counseling; suicidal and
depressed patients may benefit from
counseling or drug therapy. Demented
patients who have poisoned themselves
because of confusion about their medications should have the administration
of their medications supervised. In some
cases, poisonings are iatrogenic (i.e.,
they are due to unintended consequences of prescribed drugs or drugdrug interactions). Careful prescribing
may prevent future intoxications.
Many illnesses (e.g., massive
strokes, postictal states, insulin reactions, sepsis, meningitis, uremia) mimic
the symptoms of poisoning, esp. when the
patient has altered mental status.
acetaminophen p. Liver injury, necrosis, or failure resulting from an overdose of acetaminophen. Because acetaminophen is one of the most commonly
used over-the-counter (OTC) pain relievers, this is one of the most common
poisonings encountered in emergency
departments and hospitals. Acetaminophen is found in many OTC and prescription drugs. If a reliable history of
the amount of drug can be obtained, ingestions that exceed 7.5 g in the adult
or about 150 mg/kg in children should
always be considered potentially toxic.
In most cases, however, data about
overdoses are not reliable, and plasma
levels of acetaminophen concentration
poisoning
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are routinely measured and compared
with standard nomograms to decide
whether a patient will need antidotal
therapy with N-acetylcysteine.
CLINICAL COURSE: Shortly after ingestion, patients may suffer nausea,
vomiting, and malaise. If appropriate
treatment is not instituted, hepatitis
develops, with elevated liver enzymes in
the first day, and jaundice and coagulation disorders by about 36 hr. Encephalopathy (altered mentation, drowsiness, or coma) may follow. A prolonged
course of recovery or complete liver failure may result, depending on the
amount of drug ingested and the severity of the liver injury.
Gastrointestinal
PATIENT CARE:
(GI) decontamination with activated
charcoal absorbs toxin from the GI
tract, but it should be given within 4 hr
of ingestion of the drug. A specific antidote, N-acetylcysteine, is given orally
within 8 to 10 hr after ingestion in an
initial dose of 140 mg/kg and then in 70
mg/kg doses every 4 hr for 17 doses if
acetaminophen levels are toxic. Alternately, acetylcysteine may be administered intravenously. Blood should be
drawn for stat acetaminophen level,
CBC, electrolyte levels, BUN, serum
creatinine, serum glucose, liver function, prothrombin time, and further toxicology screens (if the presence of other
drugs is suspected). Urine also should
be analyzed for drug content. If the patient with a suspected overdose is a female of child-bearing age, a pregnancy
test should be done as a part of routine
laboratory studies. The overdosed patient should be cared for in an intensive
care unit until medically and psychiatrically cleared for discharge. SEE: Poisons and Poisoning Appendix; Rumack
nomogram.
Taking more than 4 g of acetaminophen in one day (adults) or more
than 90 mg/kg (children) can damage the
liver and may lead to coma, kidney failure,
and death.
acetanilid p. Toxicity caused by acetanilid ingestion. Symptoms are cyanosis due to formation of methemoglobin, cold sweat, irregular pulse,
dyspnea, and unconsciousness. Sudden
cardiac failure may occur.
FIRST AID: Irrigate exposed skin
with soap and water (e.g., in the safety
shower). Support breathing and oxygenation. Notify the local poison control
center. SEE: Poisons and Poisoning Appendix.
acetylsalicylic acid p. Aspirin poisoning.
acid p. Ingestion of a toxic acid. SEE:
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acids in Poisons and Poisoning in Appendix.
FIRST AID: Dilute with large volumes of water. Give demulcents and
morphine for pain. Treat as a chemical
burn.
The use of emetics and stomach
tubes is contraindicated.
acute cocaine hydrochloride p. The
acute, toxic, systemic reaction to an
overdose of cocaine that has been eaten,
smoked, inhaled, or injected. SEE:
Nursing Diagnoses Appendix.
SYMPTOMS: An overdose of cocaine is
an accelerated version of the classic
physiological and psychological responses to cocaine use. Initial euphoria
is followed by excitability, delirium,
tremors, convulsions, tachycardia, and
angina pectoris (all signs of overwhelming sympathetic stimulation of the
brain, heart, and lungs). Death is usually due to a cardiovascular event or to
respiratory failure. Plasma and liver
pseudocholinesterase detoxify cocaine
into water-soluble metabolites that are
excreted in urine. Anyone with low
plasma cholinesterase activity (e.g., fetus, infant, pregnant woman, or someone with liver disease) is esp. prone to
cocaine toxicity. People who congenitally lack pseudocholinesterase are
highly sensitive to the effects of any
dose of cocaine.
Many chronic cocaine users overdose
while taking no more than their usual
amount of the drug, when, e.g., the purity (pharmacological strength) of an ingested dose is greater than usual or the
drug has been mixed or laced with another psychoactive substance. Lethal
overdoses are usually caused by acute
coronary syndromes. Some cocaine
users may die instead of intracerebral
hemorrhage. The presenting findings
may include seizures, hemiplegia, aphasia, or coma. Patients admitted for
trauma may also be cocaine intoxicated
(two-thirds of cocaine-related deaths result from traumatic injuries, not drug
overdose). Because many signs and
symptoms that cocaine produces resemble those that result from injuries, and
because cocaine poisoning is life-threatening, emergency department care providers must quickly distinguish drugrelated problems from traumatic injury
problems.
TREATMENT: Oxygen and aspirin
should be given with benzodiazepines to
reduce agitation and calcium channel
blockers to reduce high blood pressure.
Beta blockers should be avoided.
PATIENT CARE: Vital signs are
checked frequently, the patient is attached to a cardiac monitor, and an in-
poisoning
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travenous line is initiated. Large volumes of fluids are infused to help
remove protein breakdown products
from the body (a result of rhabdomyolysis). Bilateral lung sounds are auscultated frequently during fluid resuscitation because aggressive fluid
therapy can worsen heart failure. Care
providers try to physically control patients to prevent them from injuring
themselves. If patients demonstrate violent or aggressive behavior, chemical
or physical restraints may be required.
Calcium channel blockers or a benzodiazepine is administered as prescribed to
reduce the patient’s blood pressure and
heart rate. Seizures, which occur because
the seizure threshold is lowered by cocaine, are treated with diazepam. Because
cocaine causes hypothalamic thermal regulatory dysfunction, core body temperature is monitored closely. Elevated temperature is treated with acetaminophen
and cooling blankets, cool-air ventilation,
and cool saline gastric lavage. Central
Nervous System (CNS) stimulation may
be followed by CNS depression, characterized by flaccid paralysis, coma, fixed and
dilated pupils, respiratory failure, and
cardiovascular collapse.
Cocaine smuggling often involves
“body packing” (swallowing balloons,
condoms, or other objects filled with cocaine). If these items leak, the patient
becomes intoxicated and is at high risk
for death.
If the patient survives the acute poisoning episode, treatment is directed
toward helping the patient abstain from
drugs and preventing relapses. The patient benefits from consultation with an
addictions specialist or mental health
nurse practitioner. Studies support the
effectiveness of a 12-step program, such
as Cocaine Anonymous, to help build a
solid recovery program. Other community resources also can be accessed to
provide various types of support and to
help the patient identify and manage relapse triggers.
acute lead p. The ingestion or inhalation of a large amount of lead, causing
abdominal pain, metallic taste in
mouth, anorexia, vomiting, diarrhea,
headache, stupor, renal failure, convulsions, and coma. SEE: Nursing Diagnoses Appendix.
TREATMENT: Adequate urine flow
should be established; convulsions may
be controlled with diazepam. Calcium
disodium edetate and dimercaprol are
administered to remove lead from the
body. After acute therapy is completed,
penicillamine is given orally for 3 to 6
months for children and up to 2 months
for adults. The exposure to lead should
be reduced or eliminated.
Patients receiving penicillamine
therapy must be monitored weekly
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poisoning
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for adverse reactions, including diffuse erythematous rashes, angioneurotic edema,
proteinuria, and neutropenia. Penicillamine is contraindicated in patients with a
history of penicillin sensitivity, renal disease, or both.
acute nicotine p. Excessive stimulation of the autonomic nervous system
resulting from nicotine exposure. Usually nicotine poisoning occurs when
young children accidentally consume
nicotine chewing gum or patches found
in the home. SEE: Poisons and Poisoning Appendix.
SYMPTOMS: Nausea, salivation, abdominal pain, vomiting, diarrhea,
sweating, dizziness, and mental confusion. If the dose is sufficient, the patient
will collapse, develop shock, convulse,
and die of respiratory failure due to paralysis of respiratory muscles.
Activated charcoal
TREATMENT:
may be given to conscious patients who
are not vomiting. Unconscious patients
should be intubated and supported in
an intensive care unit. Anticonvulsants
are used to treat seizures.
alkali p. Ingestion of an alkali.
TREATMENT: Large amounts of water are given by mouth. Consultation
with an ear, nose, and throat specialist
is often advisable. Tracheostomy or intubation is performed if necessary to
protect the airway. Morphine is useful
to allay pain. Rest, heat, quiet, and adequate fluid intake are imperative.
Emetics, strong acids, and lavage
should be avoided. Fluid balance
and electrolytes should be carefully monitored.
aluminum p. Nausea, vomiting, renal dysfunction, and cognitive disorders
resulting from excessive exposure to
aluminum. Aluminum poisoning (impaired cognition or “dialysis dementia”
in patients with end-stage renal disease) has been nearly eliminated now
that dialysates no longer contain aluminum.
aminophylline p. SEE: Poisons and
Poisoning Appendix.
amphetamine p. SEE: Poisons and
Poisoning Appendix.
aniline p. SEE: Poisons and Poisoning
Appendix.
antihistamine p. SEE: Poisons and
Poisoning Appendix.
antimony p. Toxicity caused by ingestion of antimony. Symptoms include
an acrid metallic taste, cardiac failure,
sweating, and vomiting about 30 min after ingestion. In large doses it causes irritation of the lining of the alimentary
tract, resembling arsenic poisoning.
FIRST AID: British antilewisite can
poisoning
be used as an antidote. SEE: arsenic in
Poisons and Poisoning Appendix.
arsenic p. Illness produced by ingestion of arsenic.
SYMPTOMS: Symptoms include a
burning pain throughout the gastrointestinal tract, vomiting, dehydration,
shock, dysrhythmias, coma, convulsions, paralysis, and death.
FIRST AID: The stomach should be
lavaged with copious amounts of water.
Dimercaprol (British antilewisite) or
other chelators (e.g., penicillamine)
should be given immediately.
TREATMENT: After first aid, fluid
and electrolyte balance must be maintained. Morphine should be given for
pain. The patient is treated for shock
and pulmonary edema. Blood transfusion may be required. SEE: arsenic in
Poisons and Poisoning Appendix.
arum family p. Poisoning caused by
ingestion of plants of the genus Arum
(e.g., dieffenbachia, caladium, and philodendron), which contain poisonous calcium oxalate crystals. Symptoms include irritation, pain, burning, and
swelling of the affected areas. The affected area should be washed with water, and ice should be applied. If pain is
severe, corticosteroids are of benefit.
aspirin p. Toxicity caused by ingesting an excessive amount of aspirin. In
acute poisoning, signs vary with increasing doses from mild lethargy and
hyperpnea to coma and convulsions.
Sweating, dehydration, hyperpnea, hyperthermia, and restlessness may be
present with moderate doses. In chronic
poisoning, tinnitus, skin rash, bleeding,
weight loss, and mental symptoms may
be present. Aspirin poisoning in very
young infants may produce very few
signs and symptoms other than dehydration or hyperpnea.
TREATMENT: Activated charcoal is
given by mouth. Intravenous (IV) fluids
are given for dehydration but must not
be overloaded. Enough IV fluids should
be given to establish 3 to 4 ml/kg/hr of
urine flow. Alkalinization of urine is
achieved by administering bicarbonate.
The goal is a urine pH of 8 or higher.
After urine flow is established, potassium 30 mEq/L of administered fluid
should be added. After serum potassium
levels reach 5 mEq/L, potassium should
be discontinued. If alkalinization of the
urine is not attained, hemodialysis may
be needed. SYN: acetylsalicylic acid poisoning. SEE: salicylates in Poisons and
Poisoning Appendix.
atropine sulfate p. Anticholinergic
side effects of atropine exposure, including restlessness, dry mouth, fever, hot
and dry skin, pupillary dilation, tachycardia, hallucinations, delirium, and
coma. SYN: atropinism.
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PATIENT CARE: Oxygen is given; a
cardiac monitor, oximeter, and automated blood pressure cuff are applied;
and intravenous fluids are administered. Patients experiencing restlessness may respond to the administration
of a benzodiazepine (e.g., lorazepam or
diazepam). If the atropine has been ingested orally, gastric lavage with activated charcoal may absorb some of the
toxin from the gastrointestinal tract.
Severe neurological side effects (e.g.,
seizures) may be treated with physostigmine. SEE: Poisons and Poisoning
Appendix.
barbiturate p. Excessive sedation,
sometimes accompanied by an inability
to protect the airway; coma; shock; and
hypothermia as a result of overdose
with barbiturates. Agents commonly
taken in overdose include secobarbital,
phenobarbital, or butalbital.
TREATMENT: When oxygenation and
ventilation are compromised, intubation and mechanical ventilation may be
needed. Other supportive treatments
include the administration of activated
charcoal, bicarbonate-containing fluids
(to make the urine alkaline and increase
barbiturate excretion), rewarming techniques, and fluids or drugs to support
blood pressure.
blood p. An outdated term for septicemia.
boric acid p. Intoxication caused by
the consumption of or exposure to boric
acid.
SYMPTOMS: Symptoms may include
nausea, vomiting, diarrhea, convulsions, weakness, central nervous system depression, livid skin rash characterized as “boiled lobster rash,” and
shock. Acute renal failure and cardiac
failure may result from large ingestions.
Activated charcoal
TREATMENT:
may prevent absorption of boric acid
from the gastrointestinal tract. Hemodialysis is sometimes required for severe intoxications. SEE: Poisons and
Poisoning Appendix.
brass p. Poisoning due to the inhalation of fumes of zinc and zinc oxide,
causing destruction of tissue in the respiratory passage. It is rarely fatal.
Symptoms include dryness and burning
in respiratory tract, coughing, headache, and chills.
Call the nearest poison control center to determine proper therapy.
brodifacoum p. Poisoning caused by
the intentional or unintentional intake
of brodifacoum. Brodifacoun, a long-acting derivative of warfarin, is often found
in rodenticides.
SYMPTOMS: Hemorrhage is the most
common side effect; it may occasionally
poisoning
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be life-threatening. Bleeding within the
kidneys and urinary tract produces
acute renal failure.
TREATMENT: Because warfarin interferes with the liver’s use of vitamin
K to produce clotting factors, brodifacoum poisoning is treated with vitamin
K, fresh frozen plasma, and supportive
therapy.
bromide p. Poisoning due to an overdose of bromide.
SYMPTOMS: Symptoms include vomiting, abdominal pain, respiratory and
eye irritation if inhaled, corrosion of the
mouth and intestinal tract if swallowed,
cyanosis, tachycardia, and shock.
FIRST AID: If bromide is inhaled,
oxygen is administered, respiratory
support provided, and pulmonary
edema treated. If bromide is swallowed,
gastric lavage may reduce intestinal absorption. SEE: Poisons and Poisoning
Appendix.
buckthorn p. Motor paralysis resulting from consumption of the fruit of the
buckthorn (a species of Bumelia) that
grows in the southeastern U.S.
camphor p. SEE: Poisons and Poisoning Appendix.
carbon dioxide p. Toxicity from carbon dioxide inhalation. In small quantities (up to about 5%) in inspired air,
CO2 stimulates respiration in humans;
in greater quantities it produces an uncomfortable degree of mental activity
with confusion. Although not toxic in
low concentrations, CO2 can cause
death by suffocation. Poisoning is rarely
fatal unless exposure occurs in a closed
space.
SYMPTOMS: Symptoms include a
sensation of pressure in the head, ringing in the ears, an acid taste in the
mouth, and a slight burning in the nose.
With massive exposures to very concentrated carbon dioxide, respiratory depression and coma may occur.
TREATMENT: The patient should be
removed to fresh air and given oxygen
and, if needed, ventilatory assistance.
carbon monoxide p. Toxicity that results from inhalation of small amounts
of carbon monoxide (CO) over a long period or from large amounts inhaled for
a short time. In the U.S., where exposure to smoke, car exhaust, and other
sources of incomplete combustion of carbon fuels is common (esp. during the
winter months), CO poisoning is one of
the most frequent, and potentially deadliest, intoxications. CO poisoning results from the avid chemical combination of the gas with hemoglobin, forming
carboxyhemoglobin (COHb). SEE: Poisons and Poisoning Appendix.
Pulse oximetry is not a useful measure in CO intoxication: it cannot
differentiate between carboxyhemoglobin
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1827
and oxyhemoglobin and therefore gives a
falsely elevated indication of oxygenation.
SYMPTOMS: The symptoms of CO
poisoning vary with the level of exposure and the concentration of COHb in
the bloodstream. At levels of less than
10%, patients may be symptom-free or
may complain only of headache. (Heavy
cigarette smoking may produce levels as
high as 7% to 9%.) COHb levels of 30%
produce mild neurological impairment
(dizziness, fatigue, difficulty concentrating), and levels of 50% may cause seizures or coma. Death is likely when
COHb levels exceed 70%.
PATIENT CARE: Arterial or venous
COHb levels should be obtained immediately, and serial levels checked hourly
to monitor treatment effectiveness.
Blood glucose, ethyl alcohol, acetaminophen, and other drug levels should be
measured on all patients who come to
the Emergency Department with altered mental status. Computed tomography or MR imaging of the brain may
also be necessary. The affected person
should be removed immediately from
exposure to CO. If the patient has severe CO poisoning (indicated by carboxyhemoglobin levels above 25%) or
cardiovascular and neurologic impairment regardless of levels, hyperbaric
oxygen therapy should be employed if
available, and the patient admitted to
the hospital. 100% oxygen is given with
a tight-fitting non-rebreather mask, under pressure (hyperbaric) if possible. Intubation and mechanical ventilation
should be used if indicated. A venous access is used to provide saline infusion,
and cardiac and hemodynamic monitoring is established. The patient should be
kept at bedrest to reduce the body’s oxygen requirements.
Potential complications of hyperbaric
therapy include sinus and middle ear
barotrauma, hyperoxic seizure, anxiety,
and oxidative stress. Intubation and
mechanical ventilation should be used
for patients with diminished level of
consciousness or respiratory distress,
esp. if hyperbaric treatment is not available. An antiemetic may be prescribed
to manage nausea and prevent vomiting. Bedrest limits exertion and tissue
oxygen demand, thus reducing organ ischemia. Patients with underlying cardiac or renal disease are necessarily at
increased risk for CO complications. In
general, people with more severe initial
symptoms are at higher risk for sequelae.
Clinical improvement after treatment
is indicated by the presence of hemodynamic stability without IV support, mechanical ventilation, or supplemental
oxygen; sufficient urine output; the return of an appetite; and a stable neu-
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rological status. A follow-up visit with a
health care professional is advisable
shortly after discharge. Patients should
be taught about the major causes of CO
exposure and should not return home
until the source of carbon monoxide has
been eliminated (e.g., by a certified
heating and ventilation specialist). The
importance of having the home heating
furnace inspected and cleaned annually
should be stressed. Patients should also
be cautioned about working on an automobile in a garage with the engine
running or burning items indoors. The
Consumer Product Safety Commission
recommends that CO detectors should
be installed on each level of the home
and just outside the sleeping areas.
Most are battery operated and easily installed. Patients should be advised to
evacuate the home if an alarm sounds,
leaving windows or doors open for ventilation, and to call 911. Alarms should
never be turned off or ignored, and batteries should be replaced when the
clocks are changed, as for smoke
alarms. SEE: table.
carbon tetrachloride p. Toxic effects
due to prolonged inhalation of carbon
tetrachloride. Consequences include irritation of the eyes, nose, and throat,
headache, confusion, central nervous
system depression, visual disturbances,
nausea, anorexia, hepatitis, nephropathy, and cardiac arrhythmias.
TREATMENT: Clothes contaminated
with carbon tetrachloride are removed.
Oxygen, artificial respiration, gastric
decontamination, and management of
cardiac rhythms are often needed. SEE:
Poisons and Poisoning Appendix.
chloride p. SEE: barium salts, absorbable, in Poisons and Poisoning Appendix.
chlorpromazine p. SEE: Poisons and
Poisoning Appendix.
chromium p. Toxicity caused by excess chromium (e.g., in mining, welding,
or pigment manufacturing). It may
cause contact dermatitis, skin burns, or
lung, liver, or kidney damage. Treatment after ingestion consists of gastrointestinal irrigation followed by forced
diuresis and alkalinization of urine.
chronic lead p. The chronic ingestion
or inhalation of lead, damaging the central and peripheral nervous systems,
kidneys, the blood-forming organs, and
the gastrointestinal tract. Early symptoms include loss of appetite, weight
loss, anemia, vomiting, fatigue, weakness, headache, lead line on gums, apathy or irritability, and a metallic taste
in the mouth. Later, symptoms of paralysis, sensory loss, lack of coordination, and vague pains develop. Laboratory diagnosis is made through evidence
of anemia, blood lead level above 5 ␮g/dl,
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poisoning
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Toxicity of Carbon Monoxide
Carbon Monoxide
Concentration in Air
Percent in Air
Parts per Million
Comment
0.005
50
0.01
100
0.02
200
0.04
400
0.08
800
0.16
1600
0.32
3200
0.64
6400
1.28
12,800
Occupational Safety and Health Administration (OSHA) maximum permissible exposure limit averaged over an 8-hr day
OSHA standard: Maritime worker peak concentration limit
OSHA standard: Brief exposures during
loading and unloading cargo are permissible
The level of CO in cigarette smoke is eight
times higher than the OSHA permissible
exposure limit
Headache, dizziness, and nausea in 45 min;
collapse and possible unconsciousness in 2
hr
Headache, dizziness, and nausea in 20 min;
collapse and possible death in 2 hr
Headache and dizziness in 5– 10 min; unconsciousness and possible death in 10– 15
min
Headache and dizziness in 1– 2 min; possible
death in 10– 15 min
Immediate unconsciousness; possible death
in 1– 3 min
SOURCES: Adapted from Hamilton, A, and Hardy, H: Industrial Toxicology, ed 3. Publishing
Sciences Group, Littleton, MA, 1974. Occupational Safety and Health Administration
(OSHA).
elevated free erythrocyte protoporphyrin (FEP), increased excretion of lead in
urine, and characteristic x-ray changes
in the ends of growing bones. SEE:
Nursing Diagnoses Appendix.
TREATMENT: Lead exposure should
be eliminated and an adequate diet with
added vitamins provided. Chelating
agents such as dimercaprol, dimercaptosuccinic acid (succimer), or EDTA are
given to reduce lead levels to normal.
PATIENT CARE: A history is obtained
to determine whether the sources of
lead ingestion or inhalation are due to
the environment, work, or folk remedies, and preparations are made for
their removal. (In many states, removal
of household lead must be done by statelicensed specialists, not homeowners.
The Centers for Disease Control and
Prevention and local poison control centers provide relevant information. A 1cm square chip of lead-based paint may
contain a thousand times the usual safe
daily ingestion of lead.) A history is obtained of pica; recent behavioral
changes, particularly lack of interest in
playing; and behavioral problems such
as aggression and hyperirritability. The
patient is assessed for developmental
delays or loss of acquired skills, esp.
speech. Central nervous system signs
indicative of lead toxicity may be irreversible. The younger child is assessed
for at-risk characteristics such as the
high level of oral activity in late infancy
and toddlerhood; small stature, which
enhances inhalation of contaminated
dust and dirt in areas heavily contaminated with lead; and nutritional deficiencies of calcium, zinc, and iron, the
single most important predisposing factor for increased lead absorption. Older
children are assessed for gasoline sniffing, which is esp. prevalent among children in some cultures. The parent-child
interaction is assessed for indications of
inadequate child care, including poor
hygienic practices, insufficient feeding
to promote adequate nutrition, infrequent use of medical facilities, insufficient rest, less use of resources for child
stimulation, less affection, and immature attitudes toward maintaining discipline. Prescribed chelating agents are
administered to mobilize lead from the
blood and soft tissues by enhancing its
deposition in bones and its excretion in
urine. A combination of drugs may result in fewer side effects and better removal of lead from the brain. If encephalopathy is present, fluid volume is
restricted to prevent additional cerebral
edema. Injections are administered intramuscularly, and injection sites are
rotated for painful injections (which
may include simultaneous procaine injection for local anesthesia). The child is
allowed to express pain and anger, and
physical and emotional comfort mea-
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sures are provided to relieve related distress. In the absence of encephalopathy,
injections are administered intravenously, and hydration is maintained.
The patient is evaluated for desired
drug effects measured by blood levels
and urinary excretion of lead (Note: special blood collection and urine collection
containers are necessary for some of the
monitoring tests. The laboratory should
be consulted before collection) and for
signs of toxicity from the chelating
agents. Prescribed anticonvulsants are
administered as necessary to control
seizures (often severe and protracted),
an antiemetic for nausea and vomiting,
an antispasmodic for muscle cramps,
and analgesics and muscle relaxants for
muscle and joint pain. Serum electrolytes are monitored daily, and renal
function is evaluated frequently. Whole
bowel irrigation is used when lead is visible in the GI tract (or for episodes of
acute lead ingestion). Adequate nutrition is provided, and nutritional deficiencies are corrected, by administering
prescribed supplements (e.g., of iron).
An active, active-assisted, or passive
range-of-motion exercise program is established to maintain joint mobility and
prevent muscle atrophy. Parents are
taught and supported to prevent recurrence, and the public is educated about
the dangers of lead ingestion, the importance of screening young (esp. preschool) children at risk, the signs and
symptoms indicative of toxicity, and the
need for treatment.
ciguatera p. A form of fish poisoning
due to eating certain types of bottomdwelling shore fish (e.g., grouper, red
snapper, sea bass, and barracuda). The
toxin, ciguatoxin, is present in fish that
feed on dinoflagellates. It acts within 5
hr of ingestion, and symptoms may persist for 8 days or longer. Symptoms include tingling of the lips, tongue, and
throat, abdominal cramps, nausea,
vomiting, diarrhea, paresthesia, hypotension, and respiratory paralysis.
Treatment is supportive, but treatment
of respiratory paralysis may be required.
codeine p. SEE: opiate poisoning;
Poisons and Poisoning Appendix.
cone shell p. A toxic reaction to the
neurotoxin delivered by the pointed,
hollow teeth of the marine animal contained in the cone shell. Intense local
pain, swelling, and numbness may last
several days. In severe poisoning, muscular incoordination and weakness can
progress to respiratory paralysis. Although death can occur, recovery within
24 hr is the usual outcome. There is no
specific therapy, but supportive measures including artificial respiration
and supplemental oxygen may be
needed.
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corrosive p. Poisoning by strong acids, alkalies, strong antiseptics including bichloride of mercury, carbolic acid
(phenol), Lysol, cresol compounds, tincture of iodine, and arsenic compounds.
These agents cause tissue damage similar to that caused by burns. If the substances have been swallowed, any part
of the alimentary canal may be affected.
Tissues involved are easily perforated.
Death may result from shock or from asphyxiation caused by swelling of the
throat and pharynx. Esophageal injury
and stricture may be a late complication. SEE: individual poisons in Poisons
and Poisoning Appendix.
SYMPTOMS: This type of poisoning is
marked by intense burning of the
mouth, throat, pharynx, and abdomen;
abdominal cramping, retching, nausea,
and vomiting, and often collapse. There
may be bloody vomit (hematemesis) and
diarrhea; the stools are watery, mucoid,
bloody, and possibly stained with the
poison or its products, resulting from its
action on the contents of the alimentary
tract. Stains of the lips, cheeks, tongue,
mouth, or pharynx are often a characteristic brown; stains on the mucous
membranes may be violet or black. Carbolic acid (phenol) stains are white or
gray, resembling boiled meat; hydrochloric acid stains are grayish, nitric
acid, yellow; sulfuric acid leaves tan or
dark burns.
TREATMENT: Immediate treatment
in a hospital is mandatory. It is important to try to discover the chemical substance ingested, and all materials such
as food, bottles, jars, or containers
should be saved. This is essential if the
patient is comatose or an infant.
In treating corrosive poisoning,
vomiting must NOT be induced;
gastric lavage must not be attempted; and
no attempt should be made to neutralize
the corrosive substance.
Vomiting will increase the severity of
damage to the esophagus by renewing
contact with the corrosive substance.
Gastric lavage may cause the esophagus
or stomach to perforate. If the trachea
has been damaged, tracheostomy may
be needed. Emergency surgery must be
considered if there are signs of possible
perforation of the esophagus or of the
abdominal viscera. Opiates will be
needed to control pain. For esophageal
burns, broad-spectrum antibiotic and
corticosteroid therapy should be
started. Intravenous fluids will be required if esophageal or gastric damage
prevents ingestion of liquids. Longrange therapy will be directed toward
preventing or treating esophageal scars
and strictures.
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iness, general muscle weakness, and visual disturbances such as blurring of vision, yellow-green or white halos
around visual images, light flashes,
photophobia, and diplopia. Mental disturbances (e.g., agitation, hallucinations, and disorientation) are esp. common in elderly atherosclerotic patients.
If the early signs are unheeded, 80% of
patients eventually will show more serious cardiac signs. Toxic concentrations of digitalis can cause nearly every
known arrhythmia. They can decrease
heart rate by slowing conduction and increasing the refractory period at the AV
node, or they can increase the rate by
creating abnormal pacemaker activity
in the conductive tissue. SEE: illus.
PATIENT CARE: The distinction between therapeutic and toxic levels digoxin is narrow; therefore, health care
providers must be alert to signs of digitalis poisoning in patients. Elderly patients and those with liver or kidney disease are at esp. high risk because their
absorption, metabolism, and excretion
rates are unpredictable. Health care
providers should consider health status
changes that can alter a patient’s response to digitalis, including vomiting,
diarrhea, or other gastrointestinal upset; acid-base or electrolyte disturbances (e.g., hypokalemia, hypomagnesemia, or hypercalcemia), which alter
the heart’s sensitivity to digitalis; hypothyroidism, which disrupts the patient’s ability to metabolize digitalis;
and liver or kidney disease, which
modifies metabolism and excretion.
Changes in a treatment regimen also
can predispose the patient to toxicity,
esp. the addition of or increase in dosages of drugs such as antiarrhythmics,
calcium channel blockers, or potassiumwasting diuretics. Assessment for digitalis toxicity is necessary if electrical
cardioversion is used to restore a patient to sinus rhythm because this procedure increases the heart’s sensitivity
to digitalis.
Because digitalis toxicity develops
quickly and insidiously, the patient is
taught early symptoms to report. Extracardiac signs can be missed or mistaken
for complications of another condition
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DIGITALIS POISONING
Atrial and junctional tachycardia caused by digitalis toxicity
cyanide p. Intoxication with any of
several cyanide-containing compounds,
very potent blockers of cellular oxygenation. They inhibit respiration by blocking oxidative phosphorylation at the cellular level. SEE: Poisons and Poisoning
Appendix.
The most common patients are jewelers, metal platers, those who handle
rodenticides, victims of smoke inhalation, and patients treated with very
high doses of sodium nitroprusside.
Rarely, cyanide poisoning results from
the ingestion of certain fruits (e.g., the
bitter cassava and some stone fruits).
SYMPTOMS: Palpitations, disorientation, and confusion may be rapidly followed by respiratory failure, seizures,
coma, and death in patients who suffer
large exposures. Smaller exposures may
produce anxiety, dizziness, headache,
and shortness of breath. Patients may
report that they have detected an odor
of bitter almonds at the time of exposure
to cyanide.
TREATMENT: The patient is immediately treated with gastric lavage, and
activated charcoal is given to adsorb to
whatever toxin may remain in the gastrointestinal tract. Emesis is contraindicated. Oxygen is immediately provided; intubation and mechanical
ventilation may be needed when the patient has suffered respiratory failure.
Antidotes to cyanide poisoning include
amyl nitrate, sodium nitrite, and sodium thiosulfate.
digitalis p. Acute or chronic toxicity
due to the cumulative effect of digitalis.
Its most common adverse effects include
anorexia, nausea, vomiting, atrial
tachycardia and other dysrhythmias,
atrioventricular heart blocks, confusion,
dizziness, or neurological depression.
Digitalis toxicity is a potentially lifethreatening, and frequently a drug-related, complication. SEE: Nursing Diagnoses Appendix.
SYMPTOMS: Extracardiac signs develop initially in most patients, the first
of which is almost always anorexia.
Nausea and vomiting, sometimes with
abdominal pain and increased salivation, usually appear 1 to 2 days later.
Other symptoms include fatigue, drows-
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being treated (e.g., pneumonia). Health
care providers need to compare the patient’s current appetite and activity to
the patient’s previous health status,
and carefully monitor the patient for
electrolyte imbalances. Significant decreases or increases in heart rate and
rhythmic irregularities must be reported because toxic concentrations
may lead to ventricular fibrillation and
death. If toxicity is suspected, an electrocardiogram is performed. Electrocardiographic signs of digitalis toxicity include first-degree atrioventricular (A-V)
block with depressed S-T segments,
shortened Q-T intervals, and flattened
T waves. In the presence of such
changes a serum digoxin level and basic
chemistries may be used to confirm toxicity. Because hypokalemia is a major
cause of digitalis toxicity, adequate potassium intake in the diet and prescribed supplementations are essential.
The patient is advised about conditions
such as diarrhea, which may deplete the
body of potassium or contribute to dehydration and renal insufficiency. The
patient is advised not to take over-thecounter medications without notifying
his health care provider because these
may alter his sensitivity to digitalis.
Digitalis poisoning may sometimes
occur because of accidental or deliberate
overdose. Emergency department personnel may sometimes remove the drug
from the stomach by lavage or activated
charcoal, administer intravenous fluids,
provide potassium, monitor cardiac
status, and/or treat cardiac arrhythmias as they arise. They may also administer digoxin immune FAB (ovine) to
bind serum digoxin, preventing it from
binding to cardiac receptors.
disulfiram p. SEE: Antabuse in Poisons and Poisoning Appendix.
ergot p. A toxic reaction from eating
bread made with grain contaminated
with the Claviceps purpurea fungus, or
from an overdose of ergot. SYN: ergotism.
SYMPTOMS: Within several hours of
ingestion, the patient may develop anticholinergic symptoms (e.g., abdominal
cramping, bradycardia, pupillary dilation, urinary retention) and vasoconstriction (with ischemia and gangrene of
the extremities).
TREATMENT: Sodium nitroprusside
may counteract the vascular spasm produced by ergots. SEE: Poisons and Poisoning Appendix.
fish p. A form of food poisoning
caused by eating fish that are inherently poisonous or poisonous because
they had decomposed, become infected,
or had fed on other poisonous life forms.
fluoride p. SEE: Poisons and Poisoning Appendix.
poisoning
food p. Illness from ingestion of
foods containing poisonous substances.
These include mushrooms; shellfish;
foods contaminated with pesticides,
lead, or mercury; milk from cows that
have fed on poisonous plants; foods that
have putrefied or decomposed, or foods
in which bacterial toxins have accumulated. SEE: staphylococcal food p.
formaldehyde p. Poisoning due to ingestion of formaldehyde.
SYMPTOMS: Symptoms include local
irritation of the eyes, nose, mouth,
throat; respiratory and gastrointestinal
tracts; central nervous system disorders
(including vertigo, stupor, convulsions,
unconsciousness); and renal damage.
SEE: Poisons and Poisoning Appendix.
gasoline p. The reaction of the body
to ingested or inhaled gasoline.
SYMPTOMS: The most hazardous
symptom of gasoline exposure is a potentially fatal inflammation of the
lungs, caused by aspiration of even
small quantities of distilled petroleum.
Symptoms of oral ingestion may also include dizziness, disorientation, seizures, and other neurological difficulties; gastric irritation and vomiting;
rashes; and cardiac rhythm disturbances.
PATIENT CARE: The exposed patient
should be observed for at least 6 hours.
If no evidence of respiratory distress or
dysfunction is found, and if a chest x-ray
exam shows no signs of chemical pneumonitis, the patient may be safely discharged home.
Patients with evidence of chemical
pneumonitis should be treated with oxygen and monitored in a hospital. Patients in full respiratory failure will require mechanical ventilation. Those
who have deliberately ingested gasoline
may benefit from supportive psychotherapy or psychiatric referral.
heavy metal p. Toxicity caused by ingestion, inhalation, or absorption of any
heavy metal, esp. lead or mercury.
Symptoms are determined by the type
and duration of exposure and may include pulmonary, neurological, integumentary, or gastrointestinal disorders.
hemlock p. Poisoning from ingesting
hemlock Conium maculatum, causing
weakness, drowsiness, nausea, vomiting, difficult breathing, paralysis, and
death.
TREATMENT: Oral activated charcoal may be given to decrease the absorption of the toxin from the gastrointestinal tract. Respiratory failure
should be treated with intubation and
mechanical ventilation. The local Poison Control Center should be contacted
for additional instructions.
herbicide p. Poisoning due to the use
of a toxic herbicide such as 2,4-D.
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hyoscyamus p. SEE: atropine in Poisons and Poisoning Appendix.
hypochlorite salt p. SEE: Poisons and
Poisoning Appendix.
iron p. Acute poisoning usually
caused by the accidental ingestion (usually by infants or small children) of ironcontaining medications intended for use
by adults. In the U.S., about 20,000 accidental iron exposures are reported
each year.
SYMPTOMS: The victim vomits, usually within an hour of taking the iron.
Vomiting of blood and melena may occur. If untreated, restlessness, hypotension, rapid respirations, and cyanosis
may develop, followed within a few
hours by coma and death.
TREATMENT: Whole bowel irrigation
should be used to force ingested iron out
of the gastrointestinal tract. Chelation
of iron can be performed with deferoxamine, which binds circulating iron
from the bloodstream.
ivy p. SEE: poison ivy dermatitis.
lead p. Ingestion or inhalation of
substances containing lead. Symptoms
of acute poisoning include a metallic
taste in the mouth, burns in the throat
and pharynx, and later abdominal
cramps and prostration. Chronic lead
poisoning is characterized by anorexia,
nausea, vomiting, excess salivation,
anemia, a lead line on the gums, abdominal pains, muscle cramps, kidney failure, encephalopathy, seizures, learning
disabilities, and pains in the joints.
TREATMENT: Seizures are treated
with diazepam. Fluid and electrolyte
balance is maintained. Cerebral edema
is treated with mannitol and dexamethasone. The blood lead level is determined. If it is above 50 to 60 ␮g/dl, the
lead is removed from the body with a
chelator (e.g., edetate calcium disodium,
dimercaprol, D-penicillamine, or succimer). Succimer has the advantage of being orally active and is esp. helpful in
treating children. The effect of treatment is monitored closely and may have
to be continued for a week or longer or
repeated if the lead level rebounds.
lye p. SEE: Poisons and Poisoning Appendix.
manganese p. An uncommon cause
of toxicity in workers exposed to manganese on a regular basis.
SYMPTOMS: Symptoms include muscular weakness, difficulty walking,
tremors, central nervous system disturbances, and salivation.
mercuric chloride p. Acute toxic reaction to ingested or inhaled salt of mercury. This form of mercury may also be
absorbed through the skin.
SYMPTOMS: Symptoms include severe gastrointestinal irritation with
pain, cramping, constriction of the
throat, vomiting, and a metallic taste in
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the mouth. Abdominal pain may be severe. Bloody diarrhea, bloody vomitus,
scanty or absent urine output, prostration, convulsions, and unconsciousness
may follow. Death from uremia is the
usual outcome unless treatment is begun immediately.
TREATMENT: Oxygen and intravenous fluids are given. Gastric lavage
(not emesis) is used to empty the gastrointestinal tract. Dimercaprol or Dpenicillamine is used for chelation. Similar treatment is given for mercurous
chloride poisoning. SEE: Poisons and
Poisoning Appendix.
mercurous chloride p. Acute toxic
reaction to ingestion or absorption
through the skin of mercurous chloride,
a mercury salt. Acute poisoning is rare
because it is poorly absorbed. Symptoms include increased salivation, abdominal discomfort, and diarrhea. SEE:
mercuric chloride in Poisons and Poisoning Appendix.
mercury p. The acute or chronic consequences of the ingestion or inhalation
of mercury. These include nausea, vomiting, abdominal pain, renal failure, gingivitis, behavioral and cognitive deficits, seizures, paralysis, pneumonitis,
and/or death.
Gastric lavage or
TREATMENT:
whole bowel irrigation may be used to
empty the gastrointestinal tract. Hemodialysis or chelation therapy (e.g.,
with succimer or penicillamine) may
also be helpful. SEE: mercuric chloride
in Poisons and Poisoning Appendix.
methyl alcohol p. Intoxication with
methanol (methyl alcohol). The initial
primary consequences are depression of
central nervous system function (including coma or convulsions), visual disturbances (including permanent blindness) due to the concentration of the
toxin in the vitreous humor and optic
nerve, headache, abdominal cramping,
nausea, weakness, and an anion-gap
metabolic acidosis.
TREATMENT: Fluids and electrolyte
and acid-base balance should be carefully monitored and adjusted. Methanol
may be removed from the bloodstream
by hemodialysis. SEE: Poisons and Poisoning Appendix.
morphine p. Acute intoxication by
injected, inhaled, or orally consumed
morphine sulfate. SEE: opiate poisoning; Poisons and Poisoning Appendix.
mushroom p., mushroom and toadstool p. Poisoning caused by ingestion
of mushrooms such as Amanita muscaria, which contains muscarine, or species that contain phalloidin, a component of the amanita toxin. The nearest
poison control center should be called
for emergency treatment. SYN: toadstool poisoning. SEE: amanita in Poisons and Poisoning Appendix.
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mussel p. Poisoning common on the
Pacific coast of the United States resulting from eating mussels or clams
that have ingested a poisonous dinoflagellate that is not destroyed by cooking.
Mussel poisoning typically occurs from
June to October.
narcotic p. Poisoning caused by narcotic or sleep-producing drugs such as
opium and its derivatives.
SYMPTOMS: The patient may experience brief exhilaration followed by
drowsiness, respiratory depression, or
coma, or, in massive overdoses, death.
TREATMENT: An airway should be
established and ventilation provided. A
narcotic antagonist such as naloxone
should be given.
nitric acid p. Injury sustained from
contact with nitric acid. Symptoms include pain, burning, vomiting, thirst,
and shock.
TREATMENT: Emergency measures
include oral administration of activated
charcoal and large volumes of water.
Emetics and stomach tubes should be
avoided because they may cause rupture of the esophagus or stomach.
opiate p. Intoxication by injected, inhaled, dermal, or orally consumed opiate or opioid analgesics.
SYMPTOMS: The patient may experience brief mental exhilaration followed by drowsiness, respiratory depression, pulmonary edema, coma, or,
in massive overdoses, death.
TREATMENT: An airway should be
established and ventilation provided. A
narcotic antagonist such as naloxone is
given, which may be repeated periodically if symptoms return. Pulmonary
edema may be treated with diuretics,
nitrates, and/or positive pressure ventilation. SEE: Poisons and Poisoning
Appendix. SYN: codeine posioning;
opium poisoning.
opium p. Opiate Poisoning.
oxalic acid p. Acute poisoning occurring when oxalic acid is accidentally ingested or when large quantities of foods
rich in oxalic acid are eaten. Ingestion
of 5 g of oxalic acid may be fatal. Chronic
poisoning may result from inhalation of
vapors. SEE: Poisons and Poisoning Appendix.
SYMPTOMS: Signs and symptoms include a corrosive action on the mucosa
of the mouth, esophagus, and stomach;
a sour taste; burning in the mouth,
throat, and stomach; great thirst;
bloody vomitus; collapse; and, sometimes, convulsions and coma.
TREATMENT: Gastric lavage should
be used to empty the gastrointestinal
tract. Activated charcoal can be given to
bind the acid. Vomiting should not be
induced.
paraldehyde p. Poisoning in which
symptoms resemble those of chloral hy-
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drate poisoning: cardiac and respiratory
depression, dizziness, and collapse with
partial or complete anesthesia. It may
also produce severe lactic acidosis.
TREATMENT: There is no specific antidote. Supportive care includes (when
appropriate) airway management, ventilation, and hemodialysis.
paraquat p. Poisoning due to ingestion of paraquat. People who have consumed paraquat may be treated with
oral activated charcoal and, if kidney
failure is present, hemodialysis.
paregoric p. SEE: opiate poisoning.
phenol p. Intoxication or chemical
burns of the skin, caused by exposure to
carbolic acid– containing compounds,
such as those found in some dyes, deodorizers, and disinfectants. These substances are corrosive to the skin and
mucous membranes. SEE: Poisons and
Poisoning Appendix.
The patient may
SYMPTOMS:
present with coagulative necrosis of affected skin or mucous membranes or
with evidence of internal organ damage.
TREATMENT: Contaminated clothing
should be removed immediately. The
skin should then be irrigated with copious amounts of water and either isopropyl alcohol or a polyethylene glycol–
containing solution. Patients who have
ingested phenols should be treated with
activated charcoal, to absorb as much
toxin as possible, and be given general
supportive care. Consultation with specialists in toxicology, otorhinolaryngology, and critical care medicine, may be
necessary in cases of massive or severe
exposure.
pokeroot p. Poisoning resulting from
ingestion of pokeroot. Nausea, vomiting, drowsiness, vertigo, and possible
convulsions and respiratory paralysis
characterize this type of poisoning.
Treatment includes administration of
whole bowel irrigation or gastric lavage.
potassium chlorate p. Poisoning by
potassium chlorate, large doses of which
cause abdominal discomfort, vomiting,
diarrhea, hematuria with nephritis, and
disturbances of the blood. Gastric lavage should be used to empty the stomach. Other treatment is symptomatic.
Vomiting should not be induced.
potassium chromate p. Poisoning by
potassium chromate, possibly contracted by inhalation or from touching
the nose with contaminated fingers,
causing deep indolent ulcers.
SYMPTOMS: When taken by mouth,
potassium chromate has a disagreeable
taste; causes cramping, pain, vomiting,
diarrhea, slow respiration; and may affect the liver and kidneys.
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1834
Vomiting should not be induced.
PATIENT CARE: For ingestion, the
patient is treated as if poisoned with a
strong acid. Gastric lavage is administered through a nasogastric tube. Bronchoalveolar lavage or penicillamine may
be used.
potassium hydroxide p. Poisoning
by potassium hydroxide, characterized
by nausea, soapy taste, and burning
pain in the mouth; bloody, slimy vomitus; abdominal cramping; bloody purging and prostration.
Vomiting should not be induced.
PATIENT CARE: The patient requires
hospitalization, morphine for pain, and,
often, treatment for shock. If the patient’s airway has been burned, topical
care is provided; tracheostomy may be
required. Corticosterioids and antibiotics may be given.
potato p. Poisoning due to ingestion
of potatoes that contain excess amounts
of solanine. This toxic substance is
present in the potato peel and in the
green sprouts. Potatoes usually contain
about 7 mg of solanine per 100 g; the
toxic dose of solanine is about 20 to 25
g. Boiling, but not baking, removes most
of the solanine from the potato. Symptoms of poisoning include headache,
vomiting, abdominal pain, diarrhea,
and fever. Neurological disturbances include apathy, restlessness, drowsiness,
confusion, stupor, hallucinations, and
visual disturbances. There is no specific
therapy. With appropriate supportive
and symptomatic therapy, prognosis is
good.
quail p. Acute myoglobinuria following ingestion of game birds of the species Coturnix coturnix. The cause is unknown but is suspected to be toxic
rather than genetic (as was once believed).
risk for p. Accentuated risk of accidental exposure to, or ingestion of,
drugs or dangerous products in doses
sufficient to cause poisoning. SEE:
Nursing Diagnoses Appendix.
salicylate p. Intoxication with aspirin or one of its derivatives. SEE: aspirin poisoning.
scombroid fish p. Intoxication due to
eating raw or inadequately cooked fish
of the suborder Scombroidea, such as
tuna and mackerel, as well as certain
non-scombroid fish, including amberjack, mahimahi, and bluefish. Certain
bacteria act on the fish after they are
caught to produce a histamine-like
toxin. Therefore, these fish should be either properly cooked and eaten shortly
poisoning
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after being caught or refrigerated immediately.
SYMPTOMS: Nausea, vomiting, abdominal cramps, diarrhea, flushing,
headache, urticaria, a burning sensation and metallic taste in the mouth,
dizziness, periorbital edema, and thirst
may develop 30 min after eating the fish
and last a few hours.
Antihistamines reTREATMENT:
verse many of the symptoms of the syndrome.
shellfish p. Poisoning produced when
humans ingest shellfish that have fed
on plankton during a red tide. There are
several recognized syndromes that may
result, including amnesic shellfish poisoning (marked by permanent loss of
short-term memory), diarrheal shellfish
poisoning, and paralytic shellfish poisoning.
silver nitrate p. Toxicity resulting
from repeated exposure to silver compounds, marked by a bluish pigmentation of the skin or occasionally of the
eyes. In the past, many medications
contained biologically available silver;
the incidence of this intoxication now,
however, is very low. SEE: argyria.
sodium fluoride p. A reaction to exposure to a toxic dose of sodium fluoride,
which is normally used in dentistry or
in fluoridating water supplies. Symptoms include conjunctivitis, nausea,
vomiting, kidney disturbances, and interference with blood coagulation.
FIRST AID: The affected areas of the
skin should be washed and the compound precipitated by addition to the
wash solution of soluble calcium salts
such as lime water, calcium gluconate,
or calcium lactate. SEE: Poisons and
Poisoning Appendix.
staphylococcal food p. Poisoning by
food containing any one of several heatstable enterotoxins produced by certain
strains of staphylococci. When ingested,
the toxin causes nausea, vomiting, diarrhea, intestinal cramps, and, in severe cases, prostration and shock. The
attack usually lasts less than a day. Fatalities are rare. Hygienic preparation
techniques can prevent this form of food
poisoning. People preparing foods
should cook all foods thoroughly, refrigerate foods during storage, and wash
hands and equipment and surfaces
used in food preparation before and after handling foods. Certain foods (e.g.,
meat, poultry, fish, and those containing mayonnaise, eggs, or cream) should
be refrigerated and used as soon as possible, and cooked until their internal
temperatures equal or exceed safe limits.
PATIENT CARE: Patients who contract food poisoning should ingest clear
fluids until abdominal pain subsides
and then gradually return to a normal
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poisoning
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diet. Fluid and electrolyte balance is
monitored, and supportive therapy is
maintained as indicated. Enteric precautions are used until evidence of infection subsides.
stramonium p. Accidental or intentional intoxication with the dried leaves
of Datura stramonium, a powerful anticholinergic agent (containing belladonna alkaloids) that produces atropine-like effects. Common signs and
symptoms include delirium and hallucinations, tachycardia and hypertension, fever, pupillary dilation, and,
sometimes, seizures, coma, cardiac
rhythm disturbances, or death. SEE: atropine sulfate poisoning.
PATIENT CARE: After the gastrointestinal tract is decontaminated with
activated charcoal, stimulation of the
intoxicated person should be minimized. Severely poisoned persons (e.g.,
those with seizures, extremely high
body temperatures, or cardiac dysrhythmias) may be treated with intravenous
physostigmine, given slowly.
strychnine p. Toxicity produced by
ingestion of strychnine.
PATIENT CARE: Overdoses should be
treated with gastric decontamination
(e.g., activated charcoal) and drugs (e.g.,
diazepam) that limit muscular contraction. Supportive care includes intravenous hydration with alkalinization of
the urine to prevent or treat the consequences of rhabdomyolysis. SEE: Poisons and Poisoning Appendix.
sulfuric acid p. Injury sustained from
contact with, or ingestion of, sulfuric
acid (e.g., in laboratories, agriculture, or
weapons manufacturing).
SYMPTOMS: Early local effects of
acid injury (e.g., necrosis of the skin or
the upper gastrointestinal tract) result
from direct contact of sulfuric acid with
the epithelium. The patient may complain of intense pain (e.g., in the mouth
or throat). If acid contacts the eye, it
may cause pain and corneal injury,
sometimes resulting in blindness. Several days to 2 weeks after massive acid
ingestion, perforation of internal organs
may occur. When the stomach is involved, the perforation may leak acid
into the mediastinum or peritoneum,
causing pain, dyspnea, hypotension,
tachycardia, or shock.
Exposed surfaces
TREATMENT:
should be promptly washed in water to
dilute the concentration of acid and
minimize the depth of acid penetration.
If the airway is compromised, the patient should be immediately intubated
and ventilated, before undergoing dilutional therapy. Activated charcoal,
which is helpful in many other exposures, is not useful. Neutralizing substances such as diluted alkalies are
probably not helpful.
poisoning
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Most patients who ingest significant
quantities of acid will undergo upper
gastrointestinal endoscopy to evaluate
the extent of the acid burn. Strictures
(e.g., esophageal) that develop as a result of scarring from acid burns are
treated with dilation. People with ocular exposures need immediate ophthalmological consultation. Immediate surgery is warranted for patients with
internal organ perforation. SEE: acids
in Poisons and Poisoning Appendix.
Blind nasogastric intubation is
generally contraindicated because
it may damage the upper gastrointestinal
tract. Gastric intubation and lavage
should be performed by experienced endoscopists.
tellurium p. A rare toxicity from the
ingestion of tellurium, usually in the
workplace. Characteristic findings include a strong garlicky odor of the
mouth and excreta; dry skin and mouth;
anorexia; weakness; and, in severe
cases, respiratory or circulatory collapse. Treatment is supportive.
thallium p. Poisoning from ingesting
thallium, characterized by severe abdominal pain, vomiting, diarrhea, tremors, delirium, convulsions, paralysis,
coma, and death. SYN: thallotoxicosis.
SEE: Poisons and Poisoning Appendix.
theophylline p. Poisoning due to excessive levels of theophylline-containing
compounds in the blood, characterized
by nausea, vomiting, agitation, cardiac
arrhythmias, and, in some instances,
seizures or death. For young patients
with asthma, theophylline levels exceeding 20 mg/dl are typically toxic;
even lower levels (e.g., 15 mg/dl) may
produce toxic effects in people over 60.
Theophylline levels above 30 mg/dl have
a high likelihood of adverse effects at
any age.
PATIENT CARE: Theophylline toxicity may occur if the patient’s symptoms
and drug levels while using theophylline-containing compounds are not monitored regularly. Many commonly used
drugs such as cimetidine, ciprofloxacin,
erythromycin, and rifampin alter the
metabolism of theophylline and may
produce toxic reactions if they are taken
during theophylline therapy. They
should be avoided. Because of the risk
of theophylline poisoning, most patients
with reactive airway diseases such as
asthma or asthmatic bronchitis are
treated with inhaled bronchodilators instead of theophylline.
The theophylline-poisoned patient
may require monitoring in a critical
care unit, where blood pressure and cardiac rhythm can be observed closely and
early interventions taken in the case of
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seizures or potentially fatal arrhythmias. Anticonvulsants are given for seizures (or to prevent seizures when theophylline levels exceed 100 mg/dl); the
gastrointestinal tract should be decontaminated with activated charcoal, and
antiarrhythmic drugs are administered,
as indicated, for cardiac rhythm disturbances. Severe overdoses or ones with
refractory symptoms should be treated
with charcoal hemoperfusion.
thiram p. Toxic exposure to thiram.
This may occur in those engaged either
in manufacturing or applying this compound in agriculture.
tin p. Poisoning that results from exposure to organic compounds containing
tin or tin arsenites. Most of the symptoms are neurological: changes in behavior, cognition, or awareness. Some
toxic effects of tin are found on electroencephalographic examination.
tincture of iodine p. Iodine poisoning.
toadstool p. Mushroom poisoning.
toluene p. SEE: benzene in Poisons
and Poisoning Appendix.
turpentine p. Toxicity resulting usually from inhalation of turpentine. SEE:
Poisons and Poisoning Appendix.
SYMPTOMS: Symptoms include a
warm or burning sensation in the
esophagus and stomach, followed by
cramping, vomiting, and diarrhea.
Pulse and respiration become weak,
slow, and irregular. Irritation of the urinary tract and central nervous system
resembles alcoholic intoxication.
FIRST AID: The airway should be secured and breathing assessed. Other
therapies are supportive (intravenous
fluids, oxygen, etc.).
p. by unknown substances Cases in
which there is no information concerning the nature of the poison taken, and
the signs and symptoms are not recognized as being due to any particular
substance. Specific antidotes cannot be
given in this situation. There are, however, certain agents that act in a general
manner and may be efficacious.
One of these is activated charcoal,
which binds most organic toxins. Whole
bowel irrigation can be used to flush ingested substances from the gastrointestinal tract. When dermal exposures are
suspected, the patient should be showered to remove chemicals from the skin.
verdigris p. Poisoning due to ingestion of verdigris, which contains copper
salts. Symptoms are identical to those
caused by ingesting copper sulfate.
SEE: copper salts in Poisons and Poisoning Appendix.
warfarin p. Excessive anticoagulation (e.g., resulting in bleeding or an increased risk of bleeding) caused by administration of an overdose of warfarin.
SEE: Poisons and Poisoning Appendix.
poisonous plants
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Many drugs interact with warfarin,
which may result in either excessive or inadequate anticoagulation. To
prevent problems with clotting or bleeding, patients taking anticoagulants should
consult with health care professionals before adding or deleting medicines from
their drug regimens.
PATIENT CARE: The patient is instructed to observe for signs of bleeding
such as epistaxis, bleeding gums, hematuria, hematochezia, hemetemesis,
melena, and bleeding into the skin (ecchymosis, purpura, or petechia). The
importance of regular blood tests (to assess the prothrombin time and international normalized ratio) and medical
follow-up is stressed. Maintaining constant intake levels of foods containing
vitamin K also is stressed, as intermittent intake can result in widely varied
coagulation levels. The patient should
wear or carry a medical identification
tag listing the prescribed drug, dosage,
and frequency of administration. Patients who have mild to moderately elevated INRs should be treated with vitamin K; patients who have serious
bleeding and warfarin poisoning should
be treated emergently with infusions of
prothrombin complex concentrate, factor IX complex concentrate, and recombinant activated factor VII. If these are
not readily available, fresh frozen
plasma may be used.
xylene p. Injury to body tissues
caused by a benzene-like compound.
SEE: benzene in Poisons and Poisoning
Appendix.
zinc phosphate p. Intoxication with
zinc phosphide, a rodenticide that
causes fatal lung and cardiac injury.
There is no specific antidote.
poisonous (poy⬘zŏn-ŭs) [L. potio, a poisonous draft] Having the properties or
qualities of a poison. SYN: toxic; venomous.
poisonous plants Plants containing a
poisonous substance that may be fatal if
ingested, including azalea, castor bean,
chinaberry, European bittersweet, wild
or black cherry, oleander, berries of
holly and mistletoe, dieffenbachia,
horse chestnuts, poison hemlock, laurel,
death cup, black nightshade or deadly
nightshade,
rhododendron,
choke
cherry, Japanese yew, unripe fruit of
akee, cassava roots, betel nut, seeds and
pods of bird-of-paradise, belladonna, angels trumpet, fava bean (if eaten by a
person with glucose-6-phosphate deficiency), foxglove, bulb of hyacinth, Indian tobacco, iris root, poinsettia, pokeroot, apricot kernels, apple seeds, green
tubers and new sprouts of potatoes,
privet, rhubarb leaves, wild tomatoes,
skunk cabbage, and jimsonweed; and
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pokeroot
1837
plants containing irritating substances,
such as poison ivy, poison oak, and poison sumac.
pokeroot (pōk⬘root) An herb, Phytolacca
americana, with white flowers and purple berries. The root is poisonous. Also
called pokeweed.
Poland syndrome (pō⬘lı̆nd) A rare developmental anomaly in which one pectoralis muscle and the fingers on the
same side of the body are hypoplastic or
aplastic. The disease is not genetically
transmitted but occurs spontaneously.
polar [L. polaris] Concerning a pole.
polar body A small nonfunctional cell
produced in oogenesis resulting from
the divisions of the primary and secondary oocytes.
polarimeter (pō⬙lă-rı̆m⬘ĕ-tĕr) [⬙ ⫹ Gr.
metron, measure] An instrument for
measuring amount of polarization of
light or rotation of polarized light.
polarimetry (pō⬙lăr-ı̆m⬘ĕ-trē) The measurement of the amount and rotation of
polarized light.
polariscope (pō-lăr⬘ı̆-skōp) [L. polaris,
pole, ⫹ Gr. skopein, to examine] An
apparatus used in the measurement of
polarized light.
polariscopy (pō⬙lăr-ı̆s⬘kō-pē) The study
of polarized light by the use of a polariscope.
polarity (pō-lăr⬘ı̆-tē) 1. The quality of
having poles. 2. The exhibition of opposite effects at the two extremities in
physical therapy. 3. The positive or negative state of an electrical battery. 4. In
cell division, the relation of cell constituents to the poles of the cell.
polarity therapy In alternative medicine,
a massage technique to promote healing
of the body by manipulating its electromagnetic currents. There is no objective
validation of this method.
polarization (pō⬙lăr-ı̄-zā⬘shŭn) [L. polaris, pole] 1. A condition in a ray of
light in which vibrations occur in only
one plane. 2. In a galvanic battery, collection of hydrogen bubbles on the negative plate and oxygen on the positive
plate, whereby generation of current is
impeded. 3. The electrical state that exists at the cell membrane of an excitable
cell at rest; the inside is negatively
charged in relation to the outside. The
difference is created by the distribution
of ions within the cell and in the extracellular fluid. SYN: potential, resting.
SEE: depolarization for illus.
polarizer (pō⬘lă-rı̄z⬙ĕr) The part of a polariscope that polarizes light.
pole (pōl) [L. polus] 1. The extremity of
any axis about which forces acting on it
are symmetrically disposed. SYN: polus. 2. One of two points in a magnet,
cell, or battery having opposite physical
qualities. 3. In biology, the regions
around each endpoint of a diameter
(esp. an axis) of a sphere.
polioencephalopathy
animal p. The pole opposite the yolk
in an ovum. At this point, polar bodies
are formed and pinched off and protoplasm is concentrated and has its greatest activity.
p. of the eye The anterior and posterior extremities of the optic axis.
frontal p. The most forward tip of the
frontal lobe of the cerebral hemisphere.
germinal p. The pole of an ovum at
which the development begins.
p. of the kidney The upper and lower
extremities of the kidney.
occipital p. The posterior extremity
of the occipital lobe.
pelvic p. The breech of a fetus.
placental p. of the chorion The spot
at which the domelike placenta is situated.
temporal p. The anterior extremity
of the temporal lobe.
policosanol (pŏl⬙ē-kŏs⬘ăn-ŏl) A mixture
of long-chain alcohols derived from
sugar cane and other natural sources. It
has been promoted as a natural lipidlowering agent. Studies sponsored by
the manufacturer of policosanol have
shown striking results, but no effect on
lipid levels was found during an independent trial performed in Germany.
polio acute anterior poliomyelitis.
polio- Combining form indicating gray.
polioclastic (pōl⬙ē-ō-klăs⬘tı̆k) [Gr. polios,
gray, ⫹ klastos, breaking] Destructive to the gray matter of the nervous
system.
polioencephalitis (pōl⬙ē-ō-ĕn-sĕf⬙ă-lı̄⬘tı̆s)
[⬙ ⫹ enkephalos, brain, ⫹ itis, inflammation] A condition characterized by
inflammatory lesions of the gray matter
of the brain.
anterior superior p. Inflammatory
changes in the gray matter around the
third ventricle, the anterior portion of
the fourth ventricle, and the aqueduct
of Sylvius. It is characterized by ocular
abnormalities, mental disturbances,
and ataxia. The origin of the disease is
thiamine (vitamin B1) deficiency. SYN:
Korsakoff’s syndrome.
p. hemorrhagica Polioencephalitis
accompanied by hemorrhagic lesions.
posterior p. Polioencephalitis involving the gray matter around the fourth
ventricle.
polioencephalomeningomyelitis (pōl⬙ēō-ĕn-sĕf⬙ăl-ō-mĕn-ı̆n⬙gō-mı̄-ĕl-ı̄⬘tı̆s)
[⬙
⫹ ⬙ ⫹ meninx, membrane, ⫹ myelos, marrow, ⫹ itis, inflammation] Inflammation of the gray matter of the
brain and spinal cord and their meninges.
polioencephalomyelitis
(pōl⬙ē-ō-ĕn-sĕf
⬙ăl-ō-mı̄⬙ĕl-ı̄⬘tı̆s) Inflammation of the
gray matter of the brain and spinal cord.
polioencephalopathy (pōl⬙ē-ō-ĕn-sĕf⬙ălŏp⬘ă-thē) [Gr. polios, gray, ⫹ enkephalos, brain, ⫹ pathos, disease, suffer-
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poliomyelencephalitis
1838
ing] Disease of the gray matter of the
brain.
poliomyelencephalitis (pōl⬙ē-ō-mı̄⬙ĕl-ĕnsĕf⬙ăl-ı̄⬘tı̆s) [⬙ ⫹ myelos, marrow, ⫹
enkephalos, brain, ⫹ itis, inflammation] Poliomyelitis with polioencephalitis.
poliomyelitis (pōl⬙ē-ō-mı̄⬙ĕl-ı̄⬘tı̆s ) [⬙ ⫹ ⬙
⫹ itis, inflammation] An acute infectious inflammation of the anterior horns
of the gray matter of the spinal cord.
abortive p. Poliomyelitis in which the
illness is mild with no involvement of
the central nervous system.
acute anterior p. An acute infectious
inflammation of the anterior horns of
the gray matter of the spinal cord, a rare
illness in the U.S. since the introduction
of effective polio vaccines. In this disease, paralysis may or may not occur. In
the majority of patients, the disease is
mild, being limited to respiratory and
gastrointestinal symptoms, such constituting the minor illness or the abortive
type, which lasts only a few days. In the
major illness, muscle paralysis or weakness occurs with loss of superficial and
deep reflexes. In such cases characteristic lesions are found in the gray matter
of the spinal cord, medulla, motor area
of cerebral cortex, and cerebellum.
ETIOLOGY: The causative agent is
the poliovirus. The virus is excreted in
the feces and remains viable for months
outside the body. Three immunological
types exist. The incubation period for infected people ranges from 5 to 35 days
but is usually 7 to 12 days.
SYMPTOMS: The onset is often
abrupt although the ordinary manifestations of a severe cold or constipation
may come on gradually, accompanied by
slight elevation of temperature, frequently enduring for not more than 3
days. At the end of this period, paralysis
may or may not develop. The extent of
paralysis necessarily depends on the degree of nerve involvement: paralysis
may be confined to one small group of
muscles or affect one or all extremities.
When the pharyngeal or respiratory
muscles are involved, death is likely to
occur unless mechanical ventilation is
provided. Extensor muscle paralysis is
typical of the disease.
DIFFERENTIAL DIAGNOSIS: The various types of meningitis, postinfection
encephalomyelitis, and, rarely, conversion disorders can be confused with polio.
PROPHYLAXIS: Active immunization
with inactivated poliovirus vaccine has
greatly reduced the incidence of paralytic poliomyelitis. SEE: inactivated poliovirus vaccine.
Paralysis and
COMPLICATIONS:
muscle atrophy are common long-term
complicatons of paralytic polio.
PROGNOSIS: Ordinarily the outcome
poliomyelitis
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is good (mortality less than 10%). When
paralysis develops, 50% of the patients
make a full recovery, and about 25%
have mild permanent paralysis.
Progressive paralysis (postpolio syndrome) may occur years after the acute
attack, often first appearing decades after the initial infection. SEE: postpoliomyelitis muscular atrophy; postpolio
syndrome.
INCIDENCE: Poliomyelitis is endemic
throughout the world but occurs in epidemics in poorer countries. Thanks to a
worldwide effort to eradicate polio
through mass vaccination, reported
cases have declined from 350,000 annually about 25 years ago, to slightly
more than 1000 cases in 2007. Polio no
longer occurs in epidemics in the U.S.
(virtually all cases for the last several
years have been vaccine-associated). In
countries where polio vaccine has not
been used extensively, epidemics are
seasonal, occurring in summer and fall.
Children are more susceptible than
adults. Infection is spread by direct contact with infected oropharyngeal secretions or feces, the virus probably entering the body via the mouth. It reaches
the central nervous system through the
blood.
TREATMENT: Treatment is supportive. Mechanical ventilation is used for
patients whose respiratory muscles are
paralyzed. Physical therapy is used to
attain maximum function and prevent
deformities that are late manifestations
of the disease.
PATIENT CARE: Strict isolation with
concurrent disinfection of throat discharge and feces is enforced to prevent
transmission of poliovirus. A patent airway is maintained; the patient is observed closely for signs of respiratory
distress; oxygen is administered as necessary, and intubation equipment or a
tracheostomy tray should be available
on a nearby crash-cart.
The patient should be kept on strict
bedrest during the acute phase. Gentle
passive range-of-motion exercises and
application of hot moist packs at 20-min
intervals (or tub baths for children) help
alleviate muscle pain. Proper body
alignment is maintained, and the patient turned frequently to prevent deformity and decubiti. A mild sedative or
analgesic is administered to decrease
pain and anxiety and to promote rest.
The patient is observed for distended
bladder due to transitory paralysis. Personal hygiene is provided, and oral hygiene is promoted. Standard precautions are employed to dispose of fecal
excretions, which contain live virus.
Fluids are provided orally (intravenously if necessary) to ensure adequate hydration and urinary output.
Appetizing food is offered because ano-
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poliomyelitis
1839
rexia is common. Antipyretics are administered to reduce fever. Fluid and
electrolyte balance and elimination are
monitored closely. A foot board or T-foot
supports are used to prevent footdrop.
Emotional support is provided. A personalized rehabilitation program is developed to assist the patient in regaining the fullest possible function. Cases
must be reported to the local health department and CDC.
anterior p. Inflammation of the anterior horns of the spinal cord.
ascending p. Poliomyelitis in which
paralysis begins in the lower extremities and progresses up the legs, thighs,
and trunk, and finally involves the respiratory muscles.
bulbar p. Poliomyelitis in which the
gray matter of the medulla oblongata is
involved, affecting respiratory nerves
and muscles supplied by the cranial
nerves, resulting in paralysis and usually respiratory failure.
chronic anterior p. Progressive wasting of the muscles; myelopathic progressive muscular atrophy.
nonparalytic p. Pain and stiffness in
the muscles of the axial skeleton, esp. of
the neck and back; mild fever; increased
proteins and leukocytes in the cerebrospinal fluid. Diagnosis depends on the
isolation of the virus and serological reactions.
paralytic p. Poliomyelitis with a variable combination of signs of damage of
the central nervous system. These include weakness, incoordination, muscle
tenderness and spasms, flaccid paralysis, and disturbance of consciousness.
SEE: postpolio syndrome.
provocative p. During an epidemic of
poliomyelitis, the onset of paralysis in
the area close to the site of an invasive
procedure. Thus an injection in muscle
increases the risk of paralysis of the side
of the body injected; and tonsillectomy
and adenoidectomy increases the risk
that poliomyelitis will affect the brain
stem.
poliosis (pŏl⬙ē-ō⬘sı̆s) [Gr. polios, gray, ⫹
osis, condition] Whiteness of the hair,
esp. when due to a hereditary condition
or as a result of infection. SYN: canities.
poliovirus (pō⬙lē-ō-vı̄⬘rŭs) The etiological agent of poliomyelitis, separable into
three serotypes based on the specificity
of the neutralizing antibody. The three
serotypes are types I, II, and III. A virus
once found worldwide, it spreads directly or indirectly from infected persons or convalescent carriers. Epidemics
of
poliomyelitis
that
were
characteristic of this virus have been
greatly reduced by the poliovirus vaccine. SEE: poliovirus vaccine, inactivated.
poliovirus vaccine, inactivated ABBR:
IPV. A poliovirus vaccine recom-
pollo-
mended for the prevention of paralytic
poliomyelitis. The vaccine, which contains inactivated types I, II, and III polioviruses, is suitable for parenteral administration to all infants and children.
Infants should be given three doses,
the first at 2 months of age, followed by
two more doses at 8-week intervals. A
fourth dose should be given at age 18
months unless poliomyelitis is endemic
in the area, in which case the fourth
dose is given 6 to 12 months after the
third. Additional doses are recommended prior to school entry and then
every 5 years until age 18.
poliovirus vaccine, live oral ABBR: OPV.
A standard preparation of one type or a
combination of the three types of live,
attenuated polioviruses. In 1999, an advisory panel to the Centers for Disease
Control and Prevention recommended
that live oral poliovirus no longer be
used routinely because it has caused 8
to 10 cases of polio each year. This risk
is no longer acceptable now that the polio epidemic has been eliminated in the
U.S. SEE: vaccine.
polishing (pŏl⬘ı̆sh-ı̆ng) Producing a
smooth, glossy finish on a denture or a
dental restoration.
Politzer bag (pŏl⬘ı̆t-sĕr) [Adam Politzer,
Hungarian otologist, 1835– 1920] A
soft rubber bag with a rubber tip for inflating the middle ear by increasing the
pressure in the nasopharynx. SEE:
aerotitis.
politzerization (pŏl⬙ı̆t-sĕr-ı̆-zā⬘shŭn) The
inflation of the middle ear by means of
a Politzer bag.
pollen (pŏl⬘ĕn) [L., dust] The microspores of a seed plant that develop in
the anther at the tip of the stamen. Each
pollen grain develops a pollen tube and
constitutes the male gametophyte.
Within it develops a tube nucleus and
two sperm nuclei, which are the male
reproductive cells. Many airborne pollens are allergens. SEE: hay fever.
pollenogenic (pŏl⬙ĕn-ō-jĕn⬘ı̆k) [⬙ ⫹ Gr.
gennan, to produce] Caused by the pollen of plants, or producing plant pollen.
pollex (pŏl⬘ĕks) pl. pollices [L.] The
thumb.
p. extensus Posterior deviation of
the thumb.
p. flexus Permanent flexion of the
thumb.
p. valgus Abnormal deviation of the
thumb toward the ulnar side.
p. varus Abnormal deviation of the
thumb toward the radial side.
pollicization (pŏl⬙ı̆s-ı̄-zā⬘shŭn) [L. pollex,
thumb] The plastic surgical procedure
of constructing a thumb from adjacent
tissues.
pollinosis (pŏl-ı̆n-ō⬘sı̆s) [L. pollen, dust,
⫹ Gr. osis, disease] Hay fever.
pollo- (pŏl⬘ō) [Sp. pollo, chicken] Combining form meaning poultry.
top of rh
base of rh
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
pollovegetarian
pollovegetarian
polycentric
top of rh
base of rh
flow (ischemia) to the areas normally
supplied by these arteries. Although
signs and symptoms depend on the location of the affected vessels and organs, patients usually present with
symptoms of multisystem disease, including fever, malaise, weight loss, hypertension, renal failure, myalgia, peripheral neuritis, and gastrointestinal
bleeding; these may occur episodically.
Unlike most types of vasculitis, polyarteritis nodosa does not affect glomerular
capillaries, although other renal vessels
are involved. The disease is associated
with hepatitis B and C, among other illnesses. SYN: periarteritis nodosa. SEE:
Nursing Diagnoses Appendix.
ETIOLOGY: The cause is unknown,
but the disease is associated with immunological disorders. Hepatitis B antigens are present in the blood of approx. 30% of patients.
polyarthritis (pŏl-ē-ăr-thrı̄⬘tı̆s) [⬙ ⫹ arthron, joint ⫹ itis, inflammation] Inflammation of more than one joint, seen
in rheumatoid arthritis, juvenile rheumatoid arthritis, and psoriatic arthritis.
It usually refers to involvement of more
than four joints. polyarthritic (pŏl⬙ē-ărthrı̆t⬘ı̆k), adj.
acute p. rheumatica An obsolete
term for acute rheumatic fever.
chronic villous p. Chronic inflammation of the synovial membrane of
multiple joints.
polyarticular (pŏl⬙ē-ăr-tı̆k⬘ū-lăr) [⬙ ⫹ L.
articulus, a joint] Concerning, having,
or affecting many joints. SYN: multiarticular.
polyatomic (pŏl⬙ē-ă-tŏm⬘ı̆k) [⬙ ⫹ atomon, atom] Having several atoms.
polyavitaminosis
(pŏl⬙ē-ā-vı̄⬙tă-mı̆nō⬘sı̆s) [⬙ ⫹ a-, not, ⫹ L. vita, life, ⫹
amine ⫹ Gr. osis, condition] A deficiency of more than one vitamin.
polybasic (pŏl⬙ē-bā⬘sı̆k) [Gr. polys,
many, ⫹ basis, base] Pert. to an acid
with two or more hydrogen ions that
will combine with a base.
polyblennia (pŏl⬙ē-blĕ⬘nē-ă) [⬙ ⫹ blennos, mucus] Secretion of an abnormal
amount of mucus.
polybrominated diphenyl ethers (pōl⬙ēbrōm⬘ı̆-nāt⬙ĕd) ABBR: PBDE. A class of
chemicals used as flame retardants.
They are chemically related to polychlorinated biphenyls and are thought to
have similar biological toxicity. They
have been found in streams, marine animals, human fetuses, and human
breast milk.
polycarbonate (pŏl⬙ē-kăr⬘bı̆-nāt, −nı̆t) [⬙
⫹ ⬙] A transparent polymer used to
manufacture eye protectors, shields,
and other medical devices.
polycarbophil (pŏl⬙ē-kăr⬘bō-fı̆l) A hydrophilic substance that is used as a bulkforming laxative.
polycentric (pŏl⬙ē-sĕn⬘trı̆k) [⬙ ⫹ ken-
short
standard
1840
(pŏl⬙ō-vĕj⬙ı̆-tār⬘ē-ı̆n) [⬙
⫹ ⬙] A person who eats a vegetarian
diet supplemented by poultry products.
pollute (pŭ-loot⬘) To ruin, contaminate,
or spoil; to make something, such as water, food, or the environment, unfit for
use or unsafe for living things.
pollution (pŭ-loo⬘shŭn) [ME. polluten]
The state of making impure or defiling.
polocyte (pō⬘lō-sı̄t) [Gr. polos, pole, ⫹
kytos, cell] Polar body.
polonium (pō-lō⬘nē-ŭm) [L. Polonia, Poland, native country of its discoverers,
the Curies] SYMB: Po. A radioactive
element isolated from pitchblende;
atomic weight 210; atomic number 84.
POLST physician orders for life-sustaining therapy.
poly (pŏl⬘ē) polymorphonuclear leukocyte.
poly- [Gr. polys, many] Combining form
indicating many, much.
polyacid (pŏl⬙ē-ăs⬘ı̆d) An alcohol or a
base with two or more hydroxyl groups
that will combine with an acid.
polyacrylonitrile (pŏl⬘ ı̆-ăk⬙ rı̆-lō-nı̄⬘ trı̆l,
trēl⬙) A synthetic polymer used in the
fabrication of dialysis membranes with
high biocompatibility.
polyadenitis (pŏl⬙ē-ăd⬙ĕ-nı̄⬘tı̆s) [⬙ ⫹ Gr.
aden, gland, ⫹ itis, inflammation] Inflammation of the lymph nodes, esp. the
cervical lymph nodes.
polyadenomatosis
(pŏl⬙ē-ăd⬙ĕ-nō-mătō⬘sı̆s) [⬙ ⫹ ⬙ ⫹ oma, tumor, ⫹ osis,
condition] Adenomas in many glands.
polyadenopathy
(pŏl⬙ē-ăd⬙ĕ-nŏp⬘ă-thē)
[⬙ ⫹ ⬙ ⫹ pathos, disease, suffering]
Any disease in which many glands are
involved.
polyadenous (pŏl⬙ē-ăd⬘ĕ-nŭs) Involving
or relating to many glands.
polyagglutination
(pŏ-lē-a-glū-tı̆nā⬘shŭn) Red cells that are agglutinated by a large proportion of adult human sera regardless of blood group.
polyalgesia (pŏl⬙ē-ăl-jē⬘zē-ă) [⬙ ⫹ algesis, sense of pain] A single stimulus
of a part, producing sensation in many
parts.
polyamide (pŏl⬙ē-ăm’ı̄d, ı̆d) [⬙ ⫹ ⬙] A
polymer used in catheters, sutures,
other biomedical devices, and clothing.
polyandry (pŏl⬙ē-ăn⬘drē) [Gr. polyandria] The practice of having more than
one husband at the same time. SEE: polygamy.
polyangiitis (pŏl⬙ē-ăn⬙jē-ı̄⬘tı̆s) [Gr. polys,
many, ⫹ angeion, vessel, ⫹ itis, inflammation] Inflammation of a number
of blood vessels.
polyarteritis nodosa (pŏl⬙ē-ăr⬙tĕr-ı̄⬘tı̆s)
[⬙ ⫹ arteria, artery, ⫹ itis, inflammation] ABBR: PAN. A form of vasculitis affecting medium and small arteries, particularly at the point of
bifurcation and branching. Segmental
inflammation and fibrinoid necrosis of
blood vessels lead to diminished blood
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
polycheiria
1841
tron, center] The condition of having
many centers.
polycheiria (pŏl⬙ē-kı̄⬘rē-ă) [⬙ ⫹ cheir,
hand] Having more than two hands.
polychemotherapy (pŏl⬙ē-kē⬙mō-thĕr⬘ăpē) [⬙ ⫹ chemeia, chemistry, ⫹ therapeia, treatment] Treatment with several chemotherapeutic agents at once.
polychlorinated biphenyl (pŏ-lē-klŏr⬘ı̆nā-tĕd) ABBR: PCB. Any of a group of
complex chemicals classed as chlorinated aromatic hydrocarbons. They
were widely used in industry as a component of transformers and capacitors;
in paints and hydraulic systems; and in
carbonless NCR paper. Because of their
extremely low rate of biodegradation,
accumulation in animal tissues (particularly in adipose tissue), and their potential for chronic or delayed toxic effects, the manufacture of PCBs was
discontinued in the U.S. in 1977.
polychondritis (pŏl⬙ē-kŏn-drı̄⬘tı̆s) [⬙ ⫹
chondros, cartilage, ⫹ itis, inflammation] Inflammation of several cartilaginous areas.
relapsing p. A rare inflammatory
disease of cartilage associated with
polyarthritis and involvement of the
cartilage of the nose, ears, joints, bronchi, and trachea. It is most common between the ages of 40 and 60 years but
may occur at any time. The cause is unknown. Because of the collapse of the
bronchial walls, repeated infections of
the lungs may occur, and death may result from respiratory compromise.
TREATMENT: Prednisone is the
treatment of choice. Immunosuppressive drugs such as cyclophosphamide or
azathioprine are used if patients fail to
respond to prednisone. Heart valve replacement or repair of aortic aneurysm
may be necessary.
polychromasia (pŏl⬙ē-krō-mā⬘zē-ă) [⬙ ⫹
chroma, color] The quality of having
many colors.
polychromatic
(pŏl⬙ē-krō-măt⬘ı̆k)
1. Multicolored. 2. Having a wide spectrum of energies or wavelengths; said of
radiation.
polychromatocyte (pŏl⬙ē-krō-măt⬘ō-sı̆t)
[⬙ ⫹ ⬙ ⫹ kytos, cell] A cell that has
an affinity for various stains. SEE: polychromatophilia (1).
polychromatophil(e) (pŏl⬙ē-krō-măt⬘ō-fı̆l)
[Gr. polys, many, ⫹ chroma, color, ⫹
philein, to love] A cell, esp. a red blood
cell that is stainable with more than one
kind of stain.
polychromatophilia
(pŏl⬙ē-krō-măt⬙ōfı̆l⬘ē-ă) 1. The quality of being stainable
with more than one stain. 2. An excess
of polychromatophils in the blood.
polychylia (pŏl⬙ē-kı̄⬘lē-ă) [⬙ ⫹ chylos,
juice] Excessive secretion of chyle.
polyclinic (pŏl⬙ē-klı̆n⬘ı̆k) [⬙ ⫹ kline,
bed] A hospital or clinic treating pa-
polycythemia
tients with various medical and surgical
conditions; a general hospital.
polyclonal (pŏl⬙ē-klōn⬘ăl) Arising from
different cell lines.
polycoria (pŏl⬙ē-kō⬘rē-ă) [⬙ ⫹ kore, pupil] The state of having more than one
pupil in one eye.
polycrotic (pŏl⬙ē-krŏt⬘ı̆k) [⬙ ⫹ krotos,
beat] Having several pulse waves for
each heartbeat.
polycrotism (pŏl-ı̆k⬘rō-tı̆zm) [⬙ ⫹ ⬙ ⫹
−ismos, condition] The condition of having several pulse waves for each heartbeat.
polycystic (pŏl⬙ē-sı̆s⬘tı̆k) [⬙ ⫹ kystis,
cyst] Composed of many cysts.
polycystic kidney disease ABBR: PKD.
Any of several hereditary disorders in
which cysts form in the kidneys and
other organs, eventually destroying kidney tissue and function. The autosomal
recessive form usually appears in early
childhood; the autosomal dominant
form usually develops later in life. Definitive treatments are dialysis and kidney transplant. Because cerebral aneurysms are commonly found in adults
with PKD, patients with this disorder
are often screened with computed tomography or magnetic resonance imaging studies of the brain.
polycystic ovary syndrome Stein-Leventhal syndrome.
polycythemia (pŏl⬙ē-sı̄-thē⬘mē-ă) [⬙ ⫹
kytos, cell, ⫹ haima, blood] An excess
of red blood cells. In a newborn, it may
reflect hemoconcentration due to hypovolemia or prolonged intrauterine hypoxia, or hypervolemia due to intrauterine
twin-to-twin
transfusion
or
placental transfusion resulting in delayed clamping of the umbilical cord.
SYN: erythrocytosis.
relative p. A relative (rather than an
absolute) increase in the number of
erythrocytes that occurs when plasma
volume is reduced (e.g., in patients with
burns or dehydration).
secondary p. Polycythemia resulting
from some physiological condition that
stimulates erythropoiesis, such as lowered oxygen tension in blood.
spurious p. Gaisböck’s syndrome.
p. vera A chronic, life-shortening myeloproliferative disorder resulting from
the reproduction of a single stem-cell
clone; characterized by proliferation or
hyperplasia of all bone marrow cells,
with an increase in red blood cell mass
and hemoglobin concentration that occurs independently of erythropoietin
stimulation. SYN: erythremia. SEE: illus.; Nursing Diagnoses Appendix.
SYMPTOMS: Usually occurring between ages 40 and 60 and most common
in males with Jewish ancestry, polycythemia seldom affects children or those
of African ancestry. Weakness, fatigue,
headache, blood clotting, vertigo, tinni-
top of rh
base of rh
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
polydactylism
1842
POLYCYTHEMIA VERA
Bone marrow showing hypercellularity and
increased megakaryocytes (arrows)
tus, irritability, dyspnea, visual disturbances, flushing of face, redness, or
ruddy cyanosis, pruritus, ecchymosis,
hypertension,
epigastric
distress,
weight loss, and pain in joints or extremities occur commonly. The bone
marrow shows uncontrolled, rapid cellular reproduction and maturation (increased cellularity). Peptic ulcers are often reported.
TREATMENT: Permanent cure cannot be achieved today, but remissions of
many years can be produced. Phlebotomy and myelosuppressive therapy (radioactive phosphorus [32P], cyclophosphamide, hydroxyurea, or melphalan)
are used.
PATIENT CARE: Pheresis returns
plasma to the patient, diluting blood
volume and reducing hypovolemia. Vital signs are monitored throughout and
following phlebotomy, the patient provided with oral fluids and protected
from orthostatic hypotension. The
symptoms and the need to seek medical
attention when signs and symptoms of
bleeding and thrombus formation occur
are explained to the patient. Rest
should be balanced with exercise, but
the patient should be advised that activity and ambulation help to prevent
thrombotic complications. Limbs should
be protected from injury due to heat,
cold, and pressure, and safety precautions, including use of a soft toothbrush,
should be instituted to prevent injury.
Reassurance and support are provided
to the patient and family, and opportunities are provided for questions and
discussion of concerns. During myelosuppressive therapy the patient is informed about adverse effects that may
occur, assessed for leukopenia and
thrombocytopenia, and protective measures are taught and instituted.
polydactylism (pŏl⬙ē-dăk⬘tı̆-lı̆zm) [Gr.
polys, many, ⫹ daktylos, digit, ⫹ −ismos, condition] The state of having supernumerary fingers or toes.
polydactyly (pŏl⬙ē-dăk⬘tı̆-lē) [⬙ ⫹ daktylos, finger] The condition of having
polygamy
top of rh
base of rh
more than the normal number of fingers
and toes.
polydipsia (pŏl⬙ē-dı̆p⬘sē-ă) [⬙ ⫹ dipsa,
thirst] Excessive thirst, a symptom
that may suggest dehydration, hyperglycemia, or hypovolemia, among other
diseases and conditions.
polydrug use (pŏ-lē-drŭg) In drug abusers, the practice of concurrent use of
several dissimilar drugs, such as alcohol, cocaine, opiates, and other drugs.
The toxic potential of multiple drug use
is increased as compared with use of a
single drug.
polydysplasia (pŏl⬙ē-dı̆s-plā⬘zē-ă) [⬙ ⫹
dys, bad, ⫹ plassein, to form] The
condition of having multiple developmental abnormalities.
polydystrophic (pŏl⬙ē-dı̆s-trō⬘fı̆k) Concerning or having polydystrophy.
polydystrophy (pŏl⬙ē-dı̆s⬘trō-fē) [⬙ ⫹ ⬙
⫹ trophe, nourishment] The condition
of having multiple congenital anomalies
of the connective tissues.
pseudo-Hurler p. Mucolipidosis type
III.
polyendocrine
deficiency
syndromes
(pŏ-lē-ĕn⬘dō-krēn) Type I: A disease
that begins at about age 12, characterized by hypoparathyroidism, primary
adrenal insufficiency, and mucocutaneous candidiasis. Alopecia, pernicious
anemia, malabsorption, and chronic
hepatitis may also be present. Type II:
A disease for which the average age of
onset is about 30 years and which is
characterized by primary adrenal insufficiency, autoimmune thyroid disease,
and insulin-dependent diabetes mellitus. SYN: autoimmune endrocrine failure syndrome.
polyene (pŏl-ē⬘ēn) An organic compound
containing alternating, or conjugate,
double bonds. An example is butadiene,
CH2 " CHCH " CH2.
polyepitope (pŏl⬙ē-ĕp⬘ı̆-tōp⬙) [⬙ ⫹ ⬙] A
synthetic merger of immunogenic protein sequences, used (e.g., in the manufacture of vaccines).
polyesthesia (pŏl⬙ē-ĕs-thē⬘zē-ă) [⬙ ⫹
aisthesis, sensation] An abnormal sensation of touch in which a single stimulus is felt at two or more places.
polyesthetic (pŏl⬙ē-ĕs-thĕt⬘ı̆k) 1. Pert. to
polyesthesia. 2. Pert. to several senses
or sensations.
polyestrous (pŏl⬙ē-ĕs⬘trŭs) [⬙ ⫹ oistros,
mad desire] Having two or more estrous cycles in each mating season.
polyethylene (pŏl⬙ē-ĕth⬘ı̆-lēn) A polymerized resin of ethylene; used to make
a wide variety of products, including
tubing used in intravenous sets.
polygalactia (pŏl⬙ē-gă-lăk⬘shē-ă) [Gr. polys, many, ⫹ gala, milk] Excessive secretion or flow of milk.
polygamy (pō-lı̆g⬘ă-mē) [⬙ ⫹ gamos,
marriage] The practice of having sev-
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
polyganglionic
1843
eral wives, husbands, or mates at the
same time. SEE: polyandry; polygyny.
polyganglionic (pŏl⬙ē-găng⬙glē-ŏn⬘ı̆k) [⬙
⫹ ganglion, ganglion] Concerning
many ganglia.
polygastria (pŏl⬙ē-găs⬘trē-ă) [⬙ ⫹ gaster, stomach] Excessive secretion or
flow of gastric juice.
polygen (pŏl⬘ĕ-jĕn) 1. An element that
has more than one valency and that can
form more than one series of compounds. 2. An antigen that will cause
the formation of two or more specific antibodies.
polygenic (pŏl⬙ē-jĕn⬘ı̆k) [⬙ ⫹ gennan, to
produce] Pert. to or caused by several
genes.
polyglactin (pŏl⬙ ē-glăk⬘ tı̆n) An absorbable polymer used to manufacture sutures and surgical mesh.
polyglandular (pŏl⬙ē-glăn⬘dū-lăr) [⬙ ⫹
L. glandula, a little kernel] Pert. to or
affecting many glands. SYN: pluriglandular.
polyglucosan (pŏl⬙ē-gloo⬘kŏ-săn⬙) Glucose polymers. Abnormal collections of
glucose polymers in tissue specimens
are sometimes called “polyglucosan bodies,” “Lafora bodies,” or “corpora amylacea.”
polyglucose, poly-D-glucose
(pŏl⬙ēgloo⬘kōs) A water-soluble polymer
made of linked dextrose subunits. It is
used as a peritoneal dialysis solution
and as a sweetener in foods.
polyglycolic acid (pŏ-lē-glı̄-kŏl⬘ı̆k) A
polymer of glycolic acid anhydride units.
It is used to manufacture surgical sutures, clips, and mesh.
polygnathus (pō-lı̆g⬘nă-thŭs) [⬙ ⫹ gnathos, jaw] Conjoined twins of unequal
size in which the smaller is attached to
the jaw of the larger.
polygram (pŏl⬘ē-grăm) [⬙ ⫹ gramma,
something written] A tracing or record
made by a polygraph.
polygraph (pŏl⬘ē-grăf) [⬙ ⫹ graphein, to
write] An instrument for determining
minor physiological changes assumed to
occur under the stress of lying (or any
other emotion). Variations in respiratory rhythm, pulse rate, blood pressure,
and sweating of the hands are among
the functions that are monitored. Increased perspiration lessens resistance
to passage of electrical current. The test
has popular appeal among law enforcement departments, but results obtained
are presumptive and not absolute; nevertheless, interpretations of polygraph
data have been admitted as evidence in
some legal proceedings. The advisability of accepting the results of polygraph
tests is controversial. SYN: sphygmograph.
polygyny (pŏ-lı̆g⬘ŏ-nē) The practice of
having more than one female mate at a
time. SEE: polygamy.
polygyria (pŏl⬙ē-jı̄⬘rē-ă) [⬙ ⫹ gyros, cir-
polyhypomenorrhea
cle] Excess of the normal number of
convolutions in the brain.
polyhedral (pŏl⬙ē-hē⬘drăl) [Gr. polys,
many, ⫹ hedra, base] Having many
surfaces.
polyhistor (pŏl⬙ē-hı̆s⬘tŭr) [⬙ ⫹ histor,
learned] A scholar or physician who
has great and varied abilities and
knowledge (e.g., Hippocrates, Galen,
Paracelsus, Leonardo da Vinci, Boerhaave, Sir William Osler, Richard
Mead, and Thomas Jefferson).
polyhybrid (pŏl⬙ē-hı̄⬘brı̆d) [⬙ ⫹ L. hybrida, mongrel] The offspring of parents that are different with respect to
three or more characteristics.
polyhydramnios (pŏl⬙ē-hı̄-drăm⬘nē-ŏs) [⬙
⫹ hydor, water, ⫹ amnion, amnion]
A condition in which the volume of amniotic fluid exceeds 2000 ml during the
last half of pregnancy. Acute polyhydramnios occurs suddenly between 20
and 24 weeks’ gestation and is marked
by a rapid (within a few days) increase
in volume. Chronic polyhydramnios, a
continuous, gradual increase in volume
throughout the last trimester, is more
common. Uterine overdistention may
result in preterm labor.
ETIOLOGY: The cause is unknown;
however, the condition occurs more frequently in association with congenital
fetal anomalies that interfere with
swallowing, in anencephaly, in monozygotic multiple gestation, and in 10%
of pregnancies in diabetic women.
SYMPTOMS: Suspicious clinical signs
include a taut abdomen, a fundal height
increased out of proportion to gestation,
and difficulty in auscultating the fetal
heart rate. When the amniotic fluid volume exceeds 3000 ml, interference with
diaphragmatic excursion and vena
caval compression are reflected in maternal shortness of breath and increased dependent edema.
DIAGNOSIS: Ultrasonography confirms the presence of polyhydramnios
and will identify fetal anomalies such as
anencephaly or exposed fetal meninges.
TREATMENT: Amniocentesis is performed to reduce the amniotic volume in
women who are experiencing severe discomfort and/or respiratory embarrassment. In most cases, however, conservative management includes bedrest in
the left lateral position to encourage
placental perfusion and diuresis.
polyhydruria (pŏl⬙ē-hı̄-droo⬘rē-ă) [⬙ ⫹ ⬙
⫹ ouron, urine] An excessive amount
of water in the urine.
polyhypermenorrhea
(pŏl⬙ē-hı̄⬙pĕrmĕn⬙ō-rē⬘ă) [⬙ ⫹ hyper, over, ⫹ men,
month, ⫹ rhoia, flow] Frequent menstruation with excessive discharge.
polyhypomenorrhea (pŏl⬙ē-hı̄⬙pō-mĕn⬙ōrē⬘ă) [⬙ ⫹ hypo, under, ⫹ men,
month, ⫹ rhoia, flow] Frequent menstruation with scanty discharge.
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polyidrosis
1844
polyidrosis (pŏl⬙ē-ı̆d-rō⬘sı̆s) [⬙ ⫹ hidro-
sis, sweat] Hyperhidrosis.
polyinfection (pŏl⬙ē-ı̆n-fĕk⬘shŭn) [⬙ ⫹
ME. infecten, infect] Infection with two
or more microorganisms. SYN: multi-infection.
polykaryocyte (pŏl⬙ē-kăr⬘ē-ō-sı̄t) [⬙ ⫹
karyon, nucleus, ⫹ kytos, cell] A cell
possessing several nuclei.
polylysine (pŏl⬙ē-lı̄⬘sı̆n) A polypeptide in
which two lysine molecules are joined.
polymastia (pŏl⬙ē-măs⬘tē-ă) [Gr. polys,
many, ⫹ mastos, breast] The condition of having more than two breasts.
SYN: multimammae.
polymastigote (pŏl⬙ē-măs⬘tı̆-gōt) [⬙ ⫹
mastix, whip] Possessing several flagella.
polymelia (pŏl⬙ē-mē⬘lē-ă) [⬙ ⫹ melos,
limb] A congenital abnormality in
which there are supernumerary limbs.
polymelus (pō-lı̆m⬘ĕ-lŭs) [⬙ ⫹ melos,
limb] One having polymelia.
polymenorrhea (pŏl⬙ē-mĕn-ō-rē⬘ă) [⬙ ⫹
⬙ ⫹ rhoia, to flow] Menstrual bleeding
that occurs regularly, but at intervals of
less than 21 days.
polymer (pŏl⬘ı̆-mĕr) [⬙ ⫹ meros, a part]
A natural or synthetic substance formed
by a combination of two or more molecules (and up to millions) of the same
substance. SYN: polymerid.
polymerase (pŏl-ı̆m⬘ĕr-ās) An enzyme
that catalyzes polymerization of nucleotides to form DNA molecules before cell
division, or RNA molecules before protein synthesis.
RNA p. Transcriptase.
polymerase chain reaction ABBR: PCR.
A process that permits making, in the
laboratory, unlimited numbers of copies
of genes. This is done beginning with a
single molecule of the genetic material
DNA. The technique can be used in investigating and diagnosing numerous
bacterial diseases, viruses associated
with cancer, genetic diseases such as diabetes mellitus, human immunodeficiency virus, pemphigus vulgaris, and
various diseases of the blood (e.g., sickle
cell anemia) and of muscles.
polymer fume fever Condition resulting
from breathing fumes produced by certain polymers when they are heated to
300⬚ to 700⬚C or higher. Symptoms include a tight gripping sensation of the
chest associated with shivering, sore
throat, fever, and weakness. Treatment
consists of discontinuance of exposure to
fumes. SEE: metal fume fever.
polymeria (pŏl-ı̆-mē⬘rē-ă) The condition
of having more than normal number of
parts. SYN: polymerism.
polymeric (pŏl⬙ı̆-mĕr⬘ı̆k) 1. Having the
characteristics of a polymer. 2. Muscles
derived from more than one myotome.
3. Consisting of repeating, linked elements.
polymerid (pō-lı̆m⬘ĕr-ı̆d) Polymer.
polymorphous light eruption
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polymerism
(pŏl⬘ı̆-mĕr⬙ı̆zm, pō-lı̆m⬘ĕrı̆zm) [⬙ ⫹ meros, part, ⫹ −ismos, condition] Polymeria.
polymerization
(pŏl⬙ı̆-mĕr⬙ı̆-zā⬘shŭn)
The process of changing a simple chemical substance or substances into another compound having the same elements usually in the same proportions
but with a higher molecular weight.
polymerize (pŏl⬘ı̆-mĕr-ı̄z) To cause polymerization.
polymersome (pŏl⬘ı̆-mĕr-sōm⬙) A vesicle
made artificially of linked, helix-shaped
proteins.
polymethyl methacrylate (pŏl⬘ı̆-mĕth⬘ı̆l
mĕth-ăk⬘rı̆-lāt⬙) A synthetic polymer
used in the fabrication of dialysis membranes with high biocompatibility.
polymicrobial (pŏl⬙ē-mı̄-krō⬘bē-ăl) [Gr.
polys, many, ⫹ mikros, small, ⫹
bios, life] Concerning a number of species of microorganisms.
polymicrobic infections (pŏ-lē-mı̄-krōbı̆k) Bacterial infections caused by two
or more different microorganisms.
polymicrogyria (pŏl⬙ē-mı̄⬙krō-jı̄⬘rē-ă) [⬙
⫹ ⬙ ⫹ gyros, convolution] A developmental malformation of the brain in
which the gyri form with abnormally
small convolutions. It often results from
chromosomal deletions, e.g., from chromosome 22.
polymorph (pŏl⬘ē-morf) [⬙ ⫹ morphe,
form] A polymorphonuclear leukocyte.
polymorphic (pŏ-lē-mŏr-fı̆k) Occurring
in more than one form. SYN: multiform;
polymorphous.
polymorphism (pŏ-lē-mŏr-fı̆zm) [⬙ ⫹
morphe, form, ⫹ −ismos, condition]
1. The property of crystallizing into two
or more different forms. 2. The occurrence of more than one form in a life cycle. 3. An allelic variation within a species. SYN: pleomorphism.
restriction fragment length p. DNA
fingerprinting with a specific nucleotide
insertion sequence.
polymorphocellular (pŏl⬙ē-mor⬙fō-sĕl⬘ūlăr) [⬙ ⫹ ⬙ ⫹ L. cellula, a small
chamber] Composed of cells of many
forms.
polymorphonuclear
(pŏl⬙ē-mor⬙fōnū⬘klē-ăr) [⬙ ⫹ ⬙ ⫹ L. nucleus, a kernel] Possessing a nucleus consisting of
several parts or lobes connected by fine
strands.
polymorphous (pŏl⬙ē-mor⬘fŭs) Polymorphic.
polymorphous light eruption, polymorphic light eruption ABBR: PMLE. A
rash occurring after exposure to sunlight, typically consisting of papules,
plaques, or papulovesicles on sun-exposed skin. It is more common in fairskinned patients and in women than in
men or people with darker skin color.
The rash is usually itchy but may produce a burning or stinging sensation.
Avoiding sun exposure with protective
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polymyalgia arteritica
1845
clothing and sunblock helps prevent
PMLE. Immune-modulating drugs are
available for refractory cases.
polymyalgia arteritica (pŏl⬙ē-mı̄-ăl⬘jē-ă)
[⬙ ⫹ mys, muscle, ⫹ algos, pain] Polymyalgia rheumatica.
polymyalgia rheumatica ABBR: PMR.
A rheumatologic illness marked by fevers, malaise, weight loss, muscle pain
and stiffness (esp. of the shoulders and
pelvis), and morning stiffness. It occurs
primarily, but not exclusively, in white
individuals over age 60. The cause of the
syndrome is unknown. Although there
is no single diagnostic test for this condition, patients typically have a markedly elevated erythrocyte sedimentation rate (⬎50 mm/hr) and no evidence
of another disease (e.g., infection, cancer, rheumatoid arthritis, or lupus) as
the underlying cause. Patients with the
syndrome obtain rapid and durable relief from corticosteroids but usually require a course of treatment lasting 6 to
18 months. Pathologically, and sometimes clinically, the syndrome is related
to giant cell arteritis. Mild cases may
sometimes respond to nonsteroidal antiinflammatory drugs. SYN: polymyalgia
arteritica.
polymyoclonus (pŏl⬙ē-mı̄-ŏk⬘lō-nŭs) [⬙
⫹ ⬙ ⫹ klonos, tumult] Paramyoclonus multiplex.
polymyositis (pŏl⬙ē-mı̄⬙ō-sı̄⬘tı̆s) [⬙ ⫹ ⬙
⫹ itis, inflammation] A relatively uncommon inflammatory disease of skeletal muscles, marked by symmetrical
weakness of the proximal muscles of the
limbs, elevated serum muscle enzymes,
evidence of muscle necrosis on biopsy,
and electromyographic abnormalities.
PATIENT CARE: Treatment regimens
may include corticosteroids, methotrexate, or other immunosuppressive
agents. Physical therapy is employed after disease activity lessens.
polymyxins (pŏl⬙ē-mı̆k⬘sı̆n) [⬙ ⫹ ⬙] Any
of the group of cationic polypeptide antibiotics produced by the bacterium Bacillus polymyxa. Although these antibiotics are toxic to the brain and kidney
and are poorly absorbed from the gastrointestinal tract, they are occasionally
used to treat resistant infections caused
by gram-negative microorganisms.
polyneural (pŏl⬙ē-nū⬘răl) [⬙ ⫹ neuron,
nerve, sinew] Pert. to, innervated, or
supplied by many nerves.
polyneuralgia (pŏl⬙ē-nū-răl⬘jē-ă) [⬙ ⫹ ⬙
⫹ algos, pain] Pain that emanates
from several nerves at the same time.
polyneuritic (pŏl⬙ē-nū-rı̆t⬘ı̆k) [⬙ ⫹ ⬙ ⫹
itis, inflammation] Inflammation of
several nerves at once.
polyneuritis (pŏl⬙ē-nū-rı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹
itis, inflammation] Multiple neuritis.
acute idiopathic p. Guillain-Barré
syndrome.
diabetic p. Diabetic neuropathy.
polyneuropathy
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Jamaica ginger p. Jamaica ginger
paralysis.
metabolic p. Polyneuritis resulting
from metabolic disorders such as nutritional deficiency, esp. the lack of thiamine; gastrointestinal disorders; or
pathologic conditions such as diabetes,
pernicious anemia, and toxemias of
pregnancy.
toxic p. Polyneuritis resulting from
poisons such as heavy metals, alcohol,
carbon monoxide, or various organic
compounds.
polyneuromyositis
(pŏl⬙ē-nū⬙rō-mı̄⬙ōsı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹ mys, muscle, ⫹ itis,
inflammation] A disease in which polyneuritis and polymyositis occur together.
polyneuropathy
(pŏl⬙ē-nū-rŏp⬘ă-thē)
[Gr. polys, many, ⫹ neuron, nerve,
sinew, ⫹ pathos, disease, suffering]
Any disease that affects multiple peripheral nerves.
acute inflammatory p. GuillainBarré syndrome.
amyloid p. Polyneuropathy characterized by deposition of amyloid in
nerves.
chronic inflammatory demyelinating
p. ABBR: CIDP. A gradually progressing autoimmune muscle weakness in
arms and legs caused by inflammation
of the myelin sheath covering peripheral nerve axons. Myelin destruction
(demyelination) slows or blocks conduction of impulses to muscles. Numbness
and paresthesia may accompany or precede loss of motor function, which varies
from mild to severe. Laboratory findings
include elevated protein levels in the
cerebrospinal fluid. The inflammatory
damage involves not only phagocytes
(neutrophils and macrophages), but also
immune complexes and complement activation by myelin autoantigens. Immunosuppressive drugs are used to
treat this illness. Plasma exchange
therapy or infusions of immunoglobulins often are used first, to produce a remission. CIDP is considered to be a
chronic counterpart to Guillain-Barré
syndrome.
critical illness p. ABBR: CIP. A complication occurring in patients in intensive care in which failure to wean from
mechanical ventilation is associated
with distal limb weakness, loss of distal
sensation from light touch or pinprick,
and diminished reflexes; facial muscles
and nerves are spared. Recovery typically occurs several weeks or months after resolution of the underlying disease.
diabetic p. Diabetic neuropathy.
familial amyloiditic p. An inherited
form of amyloid polyneuropathy in
which abnormal forms of transthyretin
are deposited in nerves and brain tissue, making multiple nerves malfunction.
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polyneuropathy
1846
paraproteinemic p. Nerve damage
caused by excessive levels of immunoglobulin in the blood. The most commonly implicated immunoglobulins are
IgM and IgG.
porphyric p. Polyneuropathy resulting from acute porphyria, characterized
by pains and paresthesias in the extremities and by flaccid paralysis.
progressive hypertrophic p. Déjérine-Sottas disease.
polyneuroradiculitis
(pŏl⬙ē-nū⬙rō-rădı̆k⬙ū-lı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹ radix, root, ⫹
itis, inflammation] Inflammation of the
nerve roots, the peripheral nerves, and
spinal ganglia.
polynuclear, polynucleate (pŏl⬙ē-nū⬘klēăr, −āt) [⬙ ⫹ L. nucleus, a kernel] Possessing more than one nucleus. SYN:
multinuclear; multinucleate.
polynucleotidase (pŏl⬙ē-nū⬙klē-ō⬘tı̆-dās)
An enzyme present in intestinal mucosa
and intestinal juice that catalyzes the
breakdown of nucleic acid to nucleotides.
polynucleotide (pŏl⬙ē-nū⬘klē-ō-tı̄d) Nucleic acid composed of two or more nucleotides.
polynucleotide kinase ABBR: PNK. An
enzyme that facilitates the transfer of a
phosphate group from adenosine triphosphate to the 5⬘ terminus of a nucleic acid (RNA or DNA).
polyodontia (pŏl⬙ē-ō-dŏn⬘shē-ă) [⬙ ⫹
odous, tooth] The state of having supernumerary teeth.
polyolefin (pŏ⬙lē-ō⬘lĕ-fı̆n) [Gr. poly-,
much, many, ⫹ L. oleum, oil] A flexible, synthethic hydrocarbon polymer.
Its health-related uses include storage
bags and containers for blood components, infusion devices and tubes for intravenous fluids, and prosthetic body
parts.
polyomavirus (pŏl⬙ē-ō-mă-vı̄⬘rŭs) A double-stranded DNA virus that causes
kidney, nerve, and lymphoid disease in
humans.
polyonychia (pŏl⬙ē-ō-nı̆k⬘ē-ă) [⬙ ⫹
onyx, nail] Having an excessive number of nails. SYN: polyunguia.
polyopia, polyopsia (pŏl⬙ē-ō⬘pē-ă, −ŏp⬘sēă) [⬙ ⫹ opsis, vision] Multiple vision;
perception of more than one image of
the same object.
polyorchidism (pŏl⬙ē-or⬘kı̆-dı̆zm) [⬙ ⫹
orchis, testicle, ⫹ −ismos, condition]
The condition of having more than two
testicles.
polyorchis (pŏl⬙ē-or⬘kı̆s) An individual
with more than two testicles.
polyostotic (pŏl⬙ē-ŏs-tŏt⬘ı̆k) [⬙ ⫹ osteon, bone] Involving several bones.
polyotia (pŏl⬙ē-ō⬘shē-ă) [⬙ ⫹ ous, ear]
The state of having more than two ears.
polyovulatory (pŏl⬙ē-ŏv⬘ū-lă-tō⬙rē) [⬙ ⫹
L. ovulum, little egg] Releasing several
ova in a single ovulatory cycle.
polyoxyl stearate (pŏl⬙ē-ŏks⬘ı̆l) Any of
polyp
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several polyoxyethylene stearates. They
have varying lengths of the polymer
chain (e.g., polyoxyl 8 stearate and polyoxyl 40 stearate have polymer lengths
of 8 and 40, respectively). They are nonionic surface-active agents that are useful emulsifiers.
polyp (pŏl⬘ı̆p) [Gr. polypous, manyfooted] A swelling or excrescence (tumor) emanating from a mucous membrane; commonly found in vascular
organs such as the nose, uterus, colon,
and rectum. Polyps bleed easily; if there
is a possibility that they will become
malignant, they should be removed surgically. SYN: polypus.
adenomatous p. Benign neoplastic
tissue originating in the glandular epithelium.
antrochoanal p. A nasal polyp found
near the posterior wall of the maxillary
sinus.
aural p. Polypoid granulation tissue
in the external canal of the ear attached
to the tympanic membrane or middle
ear structures.
bleeding p. An angioma of the nasal
mucous membrane.
cardiac p. A pedunculated tumor attached to the inside of the heart. If situated close to a valve, it may cause
blockage of the valve intermittently.
cervical p. A fibrous or mucous polyp
of the cervical mucosa.
choanal p. A nasal polyp that extends into the pharynx.
colonic p. An abnormal tissue
growth within the lumen of the colon. It
may be benign or malignant. SEE: illus.
POLYPS
Polyps in the colon, seen endoscopically
fibrinous p. A polyp containing fibrin
and blood, located in the uterine cavity.
fibroepithelial p. A smooth-surfaced
polyp of the oral mucosa, usually developing after trauma to the area. SEE: acrochordon.
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1847
polyp
NASAL POLYPS
fleshy p. A submucous myoma in the
uterus.
gelatinous p. 1. A polyp made up of
loose swollen edematous tissue. 2. A
myxoma.
Hopmann’s p. A papillary growth of
the nasal mucosa.
hydatid p. A cystic polyp.
juvenile p. A benign rounded mucosal hamartoma of the large bowel. This
type of polyp may be present in large
numbers in infants and is commonly associated with rectal bleeding. SYN: retention polyp.
laryngeal p. A polyp attached to the
vocal cords and extending to the air passageway.
lymphoid p. A benign lymphoma of
the rectum.
mucous p. A polyp of soft or jelly-like
consistency and exhibiting mucoid degeneration.
polyphalangism
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nasal p. A pedunculated polyp of the
nasal mucosa. SEE: illus.
Nasal polyps are the most commonly
identified nonmalignant tumor of the
nasal passages. They are more commonly identified in men than in women.
The most common
SYMPTOMS:
symptom of nasal polyposis is obstruction to the flow of air into and out of the
nasal passages. SEE: illus.
TREATMENT: Steroid nasal sprays
may improve airflow through the nasal
passages. Surgical removal of polyps
may occasionally be necessary when
medical treatment is unsuccessful.
placental p. A polyp composed of retained placental tissue.
retention p. Juvenile polyp.
vascular p. A pedunculated angioma.
polypapilloma (pŏl⬙ē-păp⬙ı̆-lō⬘mă) [Gr.
polys, many, ⫹ L. papilla, nipple, ⫹
Gr. oma, tumor] Yaws.
polypectomy (pŏl⬙ı̆-pĕk⬘tō-mē) [⬙ ⫹
pous, foot, ⫹ ektome, excision] The
surgical removal of a polyp. In the U.S.,
about 1 million colonic polypectomies
are performed each year.
polypeptidase (pŏl⬙ē-pĕp⬘tı̆-dās) An enzyme that catalyzes the hydrolysis of
peptides.
polypeptide (pŏl⬙ē-pĕp⬘tı̄d) [⬙ ⫹ peptein, to digest] A union of two or more
amino acids. SEE: peptide.
polypeptidorrhachia
(pŏl⬙ē-pĕp⬙tı̆-dōră⬘kē-ă) [⬙ ⫹ ⬙ ⫹ rhachis, spine]
The presence of polypeptides in the
cerebrospinal fluid.
polyphagia (pŏl⬙ē-fā⬘jē-ă) [Gr. polys,
many, ⫹ phagein, to eat] Eating abnormally large amounts of food; gluttony.
polyphalangism (pŏl⬙ē-fă-lăn⬘jı̆zm) [⬙ ⫹
NASAL
POLYPS
SUPERIOR
MIDDLE
CONCHAE
INFERIOR
NASAL POLYPS
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polypharmacy
1848
phalanx, closely knit row, ⫹ −ismos,
condition] Hyperphalangism.
polypharmacy (pŏl⬙ē-făr⬘mă-sē) [⬙ ⫹
pharmakon, drug] 1. Concurrent use of
a large number of drugs. It increases the
likelihood of unwanted side effects and
adverse drug-to-drug interactions.
PATIENT CARE: The more complicated an illness, and the more illnesses
one suffers, the greater the likelihood
that a patient will have a complex, difficult to manage, and costly drug regimen. Any person taking more than one
medication should keep a careful record
of all of his drug therapies, including
how often they are taken, for what purpose, and by whom they have been prescribed. The medical regimen should be
reviewed at each visit with health care
professionals to avoid misunderstandings and prescribing errors. Frequent
physical examinations and laboratory
studies may be needed to ensure that
complex drug regimens are not causing
preventable side effects. Medical regimens should be simplified whenever
possible to those with the greatest beneficial effect and the least likelihood of
causing harm.
2. Excessive use of drugs.
polyphenol (pŏl⬙ē-fē⬘nōl) [⬙ ⫹ ⬙] Any of
a group of colorful phytochemicals,
many of which are antioxidants.
polyphenoloxidase
(pŏl⬙ē-fē⬙nŏl-ŏk⬘sı̆dās) An enzyme present in bacteria,
fungi, and some plants that catalyzes
the oxidation of polyphenols, but not
monophenols such as tyrosine, to quinones.
polyphrasia
(pŏl⬙ē-frā⬘zē-ă)
[⬙
⫹
phrasis, speech] Excessive talkativeness.
polyphyletic (pŏl⬙ē-fı̄-lĕt⬘ı̆k) [⬙ ⫹ phyle,
tribe] Having more than one origin; opposite of monophyletic.
polyphyodont (pŏl⬙ē-fı̄⬘ō-dŏnt) [⬙ ⫹
phyein, to produce, ⫹ odous, tooth]
Developing more than two sets of teeth
at intervals during a lifetime.
polypiform (pō-lı̆p⬘ı̆-form) [⬙ ⫹ pous,
foot, ⫹ L. forma, form] Resembling a
polyp.
polypill [⬙ ⫹ L. pilula, a small mass]
1. A pill that contains a mixture of
health-promoting ingredients. 2. A panacea.
polyplastic (pŏl⬘ı̆-plăs⬘tı̆k) [⬙ ⫹ plastos,
formed] 1. Having had many evolutionary modifications. 2. Having many substances in the cellular composition.
polyplegia (pŏl⬙ē-plē⬘jē-ă) [⬙ ⫹ plege,
stroke] Paralysis affecting several
muscles.
polyploid (pŏl⬘ē-ployd) 1. Characterized
by polyploidy. 2. An individual in which
the chromosome number is two or more
times the normal haploid number.
polyploidy (pŏl⬘ē-ploy⬙dē) A condition in
which the chromosome number is two or
polysaccharide
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more times the normal haploid number
found in gametes.
polypnea (pŏl⬙ı̆p-nē⬘ă) [⬙ ⫹ pnoia,
breath] Panting.
polypodia (pŏl⬙ē-pō⬘dē-ă) [⬙ ⫹ pous,
foot] Possession of more than the normal number of feet.
polypoid (pŏl⬘ē-poyd) [⬙ ⫹ ⬙ ⫹ eidos,
form, shape] Like a polyp.
polyposia (pŏl⬙ē-pō⬘zē-ă) [⬙ ⫹ posis,
drinking] The sustained ingestion of
large amounts of fluid.
polyposis (pŏl⬙ē-pō⬘sı̆s) [⬙ ⫹ GR. pous,
foot, ⫹ ⬙] Any disease resulting in the
growth of multiple polyps.
p. coli Polyposis of the large intestine.
familial adenomatous p. SEE: familial adenomatous polyposis.
multiple intestinal p. Familial adenomatous polyposis.
p. ventriculi The presence of numerous polyps in the stomach, sometimes
involving the entire mucosa, accompanied by chronic atrophic gastritis.
polyprotein (pŏl⬘ı̆ -prō⬘tēn”) [⬙ ⫹ ⬙] A
polypeptide that contains the linked
transcripts of several proteins. Cleavage of the polypeptide releases the contained protein sequences.
polyptychial (pŏl⬙ē-tı̄⬘kē-ăl) [⬙ ⫹ ptyche, fold] Arranged in several layers, as
is the case in some glands.
polypus (pŏl⬘ı̆-pŭs) pl. polypi [L.] Polyp.
polyradiculitis (pŏl⬙ē-ră-dı̆k⬘ū-lı̄⬘tı̆s) [⬙
⫹ L. radix, root, ⫹ Gr. itis, inflammation] Inflammation of nerve roots,
esp. the roots of spinal nerves. SEE:
Nursing Diagnoses Appendix.
polyradiculoneuritis
(pŏl⬙ē-ră-dı̆k⬙ū-lōnū-rı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹ Gr. neuron, nerve,
⫹ itis, inflammation] Inflammation of
the peripheral nerves and spinal ganglia.
polyradiculopathy, acute inflammatory
(pŏ-lē-ră-dı̆-kū-lŏ⬘pă-thē)
GuillainBarré syndrome.
polyribosome (pŏl⬙ē-rı̄⬘bō-sōm) A cluster or group of ribosomes. They are the
site of attachment for mRNA in the cytoplasm and the translation of genetic
information into the synthesis of specific proteins. SYN: polysome.
polyrrhea, polyrrhoea (pōl⬙ē-rē⬘ă) [⬙ ⫹
rhoia, flow] The excessive secretion of
fluid.
polysaccharide (pŏl⬙ē-săk⬘ă-rı̄d) [⬙ ⫹
Sanskrit sarkara, sugar] One of a
group of carbohydrates that, upon hydrolysis, yield more than 20 monosaccharide molecules. They are complex
carbohydrates of high molecular weight,
usually insoluble in water, but when
soluble, they form colloidal solutions.
Their basic formula is (C6H12O6)n. They
include two groups: starch (e.g., starch,
inulin, glycogen, dextrin) and cellulose
(e.g., cellulose and hemicelluloses). The
hemicelluloses include the pentosans
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polysaccharide
1849
(e.g., gum arabic), hexosans (e.g., agaragar), and hexopentosans (e.g., pectin).
SEE: carbohydrate; disaccharide; monosaccharide.
immune p. Polysaccharides in bacteria, esp. in the cell wall, that are antigenic.
polysaccharose (pŏl⬙ē-săk⬘ă-rōs) A polysaccharide.
polyserositis (pŏl⬙ē-sē-rō-sı̄⬘tı̆s) [⬙ ⫹ L.
serum, whey, ⫹ itis, inflammation]
Inflammation of several serous membranes simultaneously. SYN: Concato’s
disease.
recurrent p. Familial Mediterranean
fever.
polysinusitis, polysinuitis (pŏl⬙ē-sı̄⬙nŭsı̄⬘tı̆s, −nū-ı̄⬘tı̆s) [⬙ ⫹ L. sinus, a hollow,
⫹ Gr. itis, inflammation] Inflammation of several sinuses simultaneously.
polysomaty
(pŏl⬙ē-sō⬘mă-tē)
[⬙
⫹
soma, body] Having reduplicated chromatin in the nucleus.
polysome (pŏl⬘ē-sōm) Polyribosome.
polysomia (pŏl⬙ē-sō⬘mē-ă) [⬙ ⫹ soma,
body] Having more than one body, as
in the doubling of the body of a fetus.
polysomnographer
(pŏl⬙ē-sŏm-nŏg⬘răfĕr) Sleep technologist.
polysomnography (pŏ-lē-sŏm-nŏ⬘gră-fē)
The simultaneous monitoring of respiratory, cardiac, muscle, brain, and ocular function during sleep. It is used most
often to diagnose sleep apnea.
polysorbates (pŏl⬙ē-sor⬘bāts) Nonionic
surface-active agents composed of polyoxyethylene esters of sorbitol. They usually contain associated fatty acids. The
series includes polysorbates 20, 40, 60,
and 80, which are used in preparing
pharmaceuticals. These polysorbates
have the trade names of Tween 20,
Tween 40, and so forth.
polyspermia (pŏl⬙ē-spĕr⬘mē-ă) [Gr. polys, many, ⫹ sperma, seed] 1. The excessive secretion of seminal fluid. 2. The
entrance of several spermatozoa into
one ovum. SYN: polyspermism.
polyspermism (pŏl⬙ē-spĕrm⬘ı̆zm) Polyspermia (2).
polyspermy (pŏl⬙ē-spĕr⬘mē) The fertilization of an ovum by multiple spermatozoa.
polystichia (pŏl⬙ē-stı̆k⬘ē-ă) [⬙ ⫹ stichos,
a row] A condition in which there are
two or more rows of eyelashes.
polystomatous (pŏl⬙ē-stō⬘mă-tŭs) [⬙ ⫹
stoma, mouth]
Possessing many
mouths or openings.
polystyrene (pŏl⬙ē-stı̄⬘rēn) A synthetic
resin produced by the polymerization of
styrene from ethylene and benzene. The
formula is (CH2CHC6H5)n. It is used in
the plastics industry.
polysulfone A synthetic polymer used in
the fabrication of dialysis membranes
with high biocompatibility.
polysynaptic (pŏl⬙ē-sı̆-năp⬘tı̆k) [⬙ ⫹
synapsis, point of contact] Pert. to
polyuria
nerve pathways involving multiple synapses.
polysyndactyly (pŏl⬙ē-sı̆n-dăk⬘tı̆l-ē) [⬙ ⫹
syn, together, ⫹ daktylos, finger]
Multiple syndactyly.
polytendinitis (pŏl⬙ē-tĕn⬙dı̆-nı̄⬘tı̆s) [⬙ ⫹
L. tendo, tendon, ⫹ Gr. itis, inflammation] Inflammation of several tendons.
polytene (pŏl⬘ĕ-tēn) [⬙ ⫹ tainia, band]
Composed of many filaments of chromatin.
polyteny (pŏl⬙ĕ-tē⬘nē) [⬙ ⫹ tainia,
band] Multiple lateral duplication of
the chromosome. This produces a giant
chromosome.
polytetrafluoroethylene (pŏ-lē-tĕ-tră-flŏrō-ĕth⬘ı̆-lēn) ABBR: PTFE. A synthetic
polymer that has slippery, nonsticking
properties. It is used in a variety of
products, including vascular grafts used
to bypass obstructed blood vessels and
grafts used for dialysis access.
polythelia (pŏl⬙ē-thē⬘lē-ă) [⬙ ⫹ thele,
nipple, ⫹ −ismos, condition] The presence of more than one nipple on a
mamma.
polytherapy (pŏl⬘ē-thĕr⬘ă-pē) Therapy
with two or more drugs used at the same
time to treat a condition. The term is
used most often to describe treatment of
seizure disorders with more than one
drug; however, it is also used to describe
multidrug therapy in Parkinson’s disease, schizophrenia, and other brain
diseases.
polytrauma (pŏl⬙ē-traw⬘mă) [⬙ ⫹ ⬙] Simultaneous injury to several organs or
body systems.
polytrichia (pŏl⬙ē-trı̆k⬘ē-ă) [⬙ ⫹ thrix,
hair] Hypertrichosis.
polytrichosis (pŏl⬙ē-trı̆-kō⬘sı̆s) [⬙ ⫹ ⬙ ⫹
osis, condition] Hypertrichosis.
polytropic (pŏl⬙ē-trŏp⬘ı̆k) [⬙ ⫹ trope, a
turning] Affecting more than one type
of cell, said of viruses, or affecting more
than one type of tissue, said of certain
poisons.
polyunguia (pŏl⬙ē-ŭng⬘gwē-ă) [⬙ ⫹ L.
unguis, nail] Polyonychia.
polyunsaturated
(pŏ-lē-ŭn-săch⬘ŭr-ātĕd) In chemistry, relating to longchain carbon compounds, esp. fats that
have many carbon atoms joined by double or triple bonds.
polyuria (pŏl⬙ē-ū⬘rē-ă) [⬙ ⫹ ouron,
urine] Excessive secretion and discharge of urine. The urine does not, as
a rule, contain abnormal constituents.
Several liters in excess of normal may
be voided each day. The urine is virtually colorless. Specific gravity is 1.000 to
1.002 (higher in diabetes mellitus).
Polyuria occurs in diabetes insipidus;
diabetes mellitus; chronic nephritis;
nephrosclerosis; hyperthyroidism; following edematous states, esp. those induced by heart failure treated with di-
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polyvalent
uretics; and following excessive intake
of liquids.
polyvalent (pŏl⬙ē-vā⬘lĕnt, pō-lı̆v⬘ă-lĕnt)
[⬙ ⫹ L. valere, to be strong] Multivalent; having a combining power of more
than two atoms of hydrogen.
polyvinyl chloride (pŏl⬙ ē-vı̄⬙ nı̆l) ABBR:
PVC. A thermoplastic polymer formed
from vinyl chloride, used in the manufacture of many products such as rainwear, garden hoses, and floor tiles.
Exposure to toxic fumes of PVC can
cause
respiratory
irritation,
asthma, or decompensation. Some evidence suggests PVCs can cause cancer.
polyvinylsiloxane Vinyl polysiloxane.
Pompe’s disease (pŏm-păz) Glycogen
storage disease type II.
(pŏm⬘fĕ-lı̆ks) A blistering
itchy rash of the hands and feet, marked
by episodic and recurring deep-seated
vesicles or bullae. The rash is most often
found in adolescents and young adults,
esp. during spring and summer. SYN:
dyshidrosis; dyshidrotic eczema. SEE:
illus.
pompholyx
POMPHOLYX
ETIOLOGY: Although the cause is unknown, emotional stress, an allergic
predisposition, and fungal infections
have each been associated with episodes
of the rash.
TREATMENT: Burow’s or permanganate solution and potent topical steroids
sometimes are effective. The rash tends
to appear less often as patients reach
middle age.
POMR problem-oriented medical record.
ponderal
(pŏn⬘dĕr-ăl)
[L. pondus,
weight] Relating to weight.
pons (pŏnz, pŏn⬘tēz⬙) pl. pontes [L.,
bridge] A process of tissue connecting
two or more parts.
Pontiac fever (pŏn⬘ tē-ăk⬙) [Fm. Pontiac,
MI, where an outbreak occurred in one
building in 1986] An infection with Legionella species that causes fevers,
chills, headache, muscle aches, gastrointestinal upset, and prostration but not
pneumonia.
poradenitis
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pontic (pŏn⬘tı̆k) [L. pons, pontis, bridge]
An artificial tooth set in a bridge.
pontile (pŏn⬘tēl) Pert. to the pons varolii.
pontile nuclei The gray matter in the
pons.
pontine (pŏn⬘tēn) Pert. to the pons varolii.
pontobulbar
(pŏn⬙tō-bŭl⬘bar) Pert. to
the pons and medulla oblongata.
pool 1. To mix blood from several donors.
2. The accumulation of blood in a body
site. 3. A source of similar substances or
cells.
abdominal p. The accumulation of
blood in the visceral organs of the abdominal cavity. This may occur as a result of abdominal trauma.
amino acid p. The amino acids available for protein synthesis at any given
time; the liver regulates the blood level
of amino acids based on tissue needs
and converts excess amino acids to carbohydrates for energy production.
gene p. The sum of the genetic material in the members of a specified population.
metabolic p. All of the chemical compounds included in metabolic processes
in the body.
vaginal p. The mucus and cells that
are present in the posterior fornix of the
vagina when the patient is in a supine
position. Material obtained from this
site is used in cancer detection and in
evaluating the character of the vaginal
fluid in investigating infertility problems.
popliteus (pŏp-lı̆t⬘ē-ŭs, −lı̆t-ē⬘ŭs) [L. poples, ham of the knee] Muscle located
in the hind part of the knee joint that
flexes the leg and aids it in rotating.
popliteal (pŏp⬙lı̆t-ē⬘ăl, pŏp-lı̆t⬘ē-ăl), adj.
poppy (pŏ⬘pē) Any of the several plants
of the genus Papaver. Opium is obtained
from the juice of the unripe pods of Papaver somniferum.
population 1. All persons, plants, or animals inhabiting a specified area. 2. The
group of persons from which a research
sample is drawn.
population density The number of organisms, usually people, living within a
defined space, such as a city, county, or
town. In the U.S., regions with greater
population densities tend to have different health care problems than lightly
populated ones. Conditions such as gunshot wounds, HIV/AIDS, and tuberculosis are more common in metropolitan
areas than in rural areas. Urban living
confers some advantages, however, in
that densely populated areas tend to
have a greater health care infrastructure and more professional resources
than rural areas.
POR problem-oriented record.
poradenitis (por⬙ăd-ĕ-nı̄⬘tı̆s) [Gr. poros,
passage, ⫹ aden, gland, ⫹ itis, in-
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1851
flammation] The formation of small abscesses in the iliac lymph nodes.
porcelain (por⬘sĕ-lı̆n) A hard, translucent ceramic made by fusing clay,
quartz, and feldspar. The combination
is colored by glazing with fusible pigments. It is used in dentistry to construct restorations and prosthetics.
porcelaneous, porcelanous
(por⬙sĕlā⬘nē-ŭs, −sĕl⬘ăn-ŭs) [Fr. porcelaine]
Translucent or white like porcelain.
porcine (por⬘sı̄n) [L. porcus, pig] Relating to or concerning swine.
pore (por) [Gr. poros, passage.] 1. A
minute opening, esp. one on an epithelial surface. SEE: porus. 2. The opening
of the secretory duct of a sweat gland.
SEE: skin; stoma; sweat glands.
alveolar p. A minute opening that is
thought to exist between adjacent alveoli of the lung.
gustatory p. Taste pore.
taste p. The external opening of a
taste bud. SYN: gustatory pore. SEE:
taste.
porencephalia, porencephaly (por⬙ĕnsĕf-ā⬘lē-ă, por⬙ĕn-sĕf⬘ă-lē) [⬙ ⫹ enkephalos, brain] An anomalous condition in which the ventricles of the brain
are connected with the subarachnoid
space.
porencephalitis (por⬙ĕn-sĕf⬙ă-lı̄⬘tı̆s) [⬙ ⫹
⬙ ⫹ itis, inflammation] Inflammation
of the brain with development of cavities communicating with the subarachnoid space.
pori (pŏr-ē) Pl. of porus.
Porifera (pŏ-rı̆f⬘ĕ-ră) [NL. porus, opening
⫹ ferre, to bear] The phylum of sea
sponges, some of which are toxic to humans.
porin (pŏr⬘ı̆n) [Gr. poros, passageway] A
channel-forming protein in cell membranes that facilitates the diffusion of
water and small molecules in and out of
the cell.
porocephaliasis, porocephalosis (pō⬙rōsĕf⬙ă-lı̄⬘ă-sı̆s, −lō⬘sı̆s) [⬙ ⫹ kephale,
head, ⫹ −iasis, state or condition of]
Infection with a species of Porocephalus.
Porocephalus (pō⬙rō-sĕf⬘ă-lŭs) a genus
of helminthoid arthropods. The species
parasitic in humans have been assigned
to other genera. SEE: Armillifer.
porokeratosis (pō⬙rō-kĕr⬙ă-tō⬘sı̆s) [⬙ ⫹
keras, horn, ⫹ osis, condition] A rare
skin disease marked by thickening of
the stratum corneum in a linear arrangement, followed by its atrophy. Porokeratosis appears on smooth areas. It
is irregular in form and size with a circumscribed outline and affects the
hands and feet, forearms and legs, the
face, neck, and scalp.
poroma (pō-rō⬘mă) [Gr.] 1. Callosity.
2. A tumor of cells lining the opening of
the sweat glands.
cerebral p. At postmortem examination, the presence of cavities in the brain
porphyria
substance caused by gas-forming bacteria.
eccrine p. A tumor arising from the
duct of an eccrine gland; usually occurring on the palm or sole.
porosis (pō-rō⬘sı̆s) [Gr. poros, passage,
⫹ osis, condition] Callus formation in
repair of fractured bone. SEE: callus.
-porosis Suffix meaning porous.
porosity (pō-rŏs⬘ı̆-tē) [Gr. poros, passage] The state of being porous.
porous (pō⬘rŭs) Full of pores; able to let
liquid pass.
porphin (por⬘fı̆n) The basic ring structure forming the framework of all porphyrins. It consists of four pyrrole rings
united by methene couplings.
porphobilinogen (por⬙fō-bı̄-lı̆n⬘ō-jĕn) An
intermediate product in heme synthesis
sometimes found in the urine of patients
with acute porphyria. The urine may
appear normal when fresh but will
change to a burgundy wine color or even
to black when heated with dilute hydrochloric acid to 100⬚C.
porphyria (por-fı̄⬘rē-ă, por-fı̆r⬘ē-ă) [Gr.
porphyra, purple] A group of disorders
that result from a disturbance in any of
the sequential steps involved in the synthesis of heme, causing increased formation and excretion of porphyrin or its
precursors.
acute intermittent p. A rare metabolic disorder inherited as an autosomal
dominant trait. It is characterized by
excessive excretion of porphyrins, episodes of acute abdominal pain, sensitivity to light, and neurological disturbances. The disorder is sometimes
precipitated by the excessive use of sulfonamides, barbiturates, or other drugs.
congenital erythropoietic p. A rare
condition inherited as an autosomal recessive trait. It is characterized by severe skin lesions, hemolytic anemia,
and splenomegaly.
p. cutanea tarda A form of porphyria
in which patients develop liver disease
and rashes on parts of their bodies exposed to the sun (e.g., on the knuckles
or face). The use of alcohol or estrogens
may worsen the condition. The cause is
a deficiency of uroporphylinogen decarboxylase.
p. erythropoietica A mild form of
porphyria characterized by cutaneous
lesions and excess protoporphyrin in the
erythrocytes and feces. SYN: protoporphyria.
p. hepatica Porphyria caused by a
disturbance in liver metabolism such as
occurs following hepatitis, poisoning by
heavy metals, certain anemias, and
other conditions.
South African genetic p. Variegate
porphyria.
variegate p. A form of hepatic porphyria in which there are recurrent episodes of abdominal pain and neuropa-
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porphyrin
position
top of rh
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radiation oncology an x-ray image used
to verify the positioning of the patient
within the planned treatment field.
portoenterostomy, hepatic (pŏr-tō-ĕntĕr-ŏs⬘tō-mē) A surgical procedure performed to establish bile flow in an infant
who has external biliary atresia associated with absence of the extrahepatic
biliary system. A section of the jejunum
is attached to the liver at the normal
exit site of the hepatic duct to allow bile
drainage into the small intestine. The
jejunal segment may be looped to form
a cutaneous double-barreled ostomy.
Postoperatively, liver function continues to deteriorate in most children, and
liver transplantation is often needed.
SYN: Kasai procedure.
portogram (por⬘tō-grăm) [L. porta, gate,
⫹ Gr. gramma, something written] A
radiograph of the portal vein after injection of a contrast medium.
portography (por-tŏg⬘ră-fē) [⬙ ⫹ Gr.
graphein, to write] Radiography of the
portal vein after injection of a radiopaque contrast medium.
portal p. Portography after injection
of opaque material into the superior
mesenteric vein. This is usually done
during laparotomy.
splenic p. Radiography of the splenic
and portal veins after injection of a contrast medium into the splenic artery.
portosystemic (por⬙tō-sı̆s-tĕm⬘ı̆k) Joining the portal and systemic venous circulation.
Portuguese man-of-war A type of jellyfish, Physalia physalis, whose tentacles
contain a neurotoxin that produces a
burning sensation on contact. SEE: bite.
port-wine stain (pŏrt⬘wı̄n) Nevus flammeus.
porus (pō⬘rŭs) pl. pori [L.] A meatus or
foramen; a tiny aperture in a structure;
a pore.
p. acusticus, internal The opening of
the internal acoustic meatus into the
cranial cavity.
p. gustatorius The small taste pore
openings in the taste buds of the tongue.
position (pō-zı̆sh⬘ŭn ) [L. positio ] 1. The
place or arrangement in which a thing
is put. 2. The manner in which a body is
arranged, as by the nurse or physician
for examination. 3. In obstetrics, the relationship of a selected fetal landmark
to the maternal front or back, and on the
right or left side. SEE: table; presentation for illus.
anatomical p. The position assumed
when a person is standing erect with
arms at the sides, palms forward. SYN:
orthograde position.
anteroposterior p. A radiographical
examination position in which the central ray enters the front of the body and
exits from the back.
antideformity p. Any one of several
postures that reduce edema and the
short
standard
1852
thy. The skin is esp. fragile. SYN: South
African genetic porphyria.
porphyrin (por⬘fı̆-rı̆n) [Gr. porphyra,
purple] Any of a group of nitrogen-containing organic compounds; they form
the basis of animal and plant respiratory pigments; obtained from hemoglobin and chlorophyll.
porphyrinuria (por⬙fı̆-rı̆-nū⬘rē-ă) [⬙ ⫹
ouron, urine] Excretion of an increased
amount of porphyrin in the urine. SYN:
porphyruria.
Porphyromonas (pōr⬙ fı̆-rō-mōn⬘ ăs) [Gr.
porphyra, purple ⫹ monas, single] A
genus of gram-negative, rod-shaped, anaerobic bacteria that inhabits the oral
cavity. One species, Porphyromonas
gingivalis, is a common cause of gingivitis and periodontal infection.
porphyruria (por⬙fı̆r-ū⬘rē-ă) [⬙ ⫹ ouron,
urine] Porphyrinuria.
PORT (pŏrt) patient outcomes research
team.
porta (pŏr⬘tă) [L., gate] The point of entry of nerves and vessels into an organ
or part.
p. hepatis The fissure of the liver
where the portal vein and hepatic artery
enter and the hepatic duct leaves.
portable (pŏr⬘tă-bul) [L. portare, to
carry] Movable or transferable from
one place to another, e.g., a portable
oxygen supply.
portacaval (por⬙tă-kā⬘văl) Concerning
the portal system and the vena cava.
portal (pŏr⬘tăl) [L. porta, gate] 1. An entryway. 2. Concerning a porta or entrance to an organ, esp. that through
which the blood is carried to the liver.
p. of entry The pathway by which infectious organisms gain access to the
body (e.g., respiratory tract, breaks in
skin).
p. of exit The pathway by which
pathogens leave the body of a host (e.g.,
respiratory droplets, feces, urine,
blood).
intestinal p. The opening of the midgut or yolk sac into the foregut or hindgut of an embryo.
positioning p. Surgical portal.
surgical p. An opening in the skin
through which a surgical instrument
(e.g., a fiberoptic scope) may be placed.
SYN: positioning portal.
p. vein Vein formed by the union of
veins from the abdominal viscera, which
then takes blood into the liver. It is
made of the combined superior and inferior mesenteric, splenic, gastric, and
cystic veins.
portal system A system of vessels in
which blood passes through a capillary
network, a large vessel, and then another capillary network before returning to the systemic circulation (e.g., the
circulation of blood through the liver).
port film (pŏrt) [L. porta, door, gate] In
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1853
position
Positions of Fetus in Utero
Vertex Presentation
(point of designation— occiput)
Left occiput anterior
Right occiput posterior
Right occiput anterior
Left occiput posterior
Right occiput transverse
Occiput anterior
Occiput posterior
LOA
ROP
ROA
LOP
ROT
OA
OP
Breech Presentation (point of
designation— sacrum)
Left sacroanterior
Right sacroposterior
Right sacroanterior
Left sacroposterior
Sacroanterior
Sacroposterior
Left sacrotransverse
Right sacrotransverse
LSA
RSP
RSA
LSP
SA
SP
LST
RST
Face Presentation (point of
designation— mentum)
Left mentoanterior
Right mentoposterior
Right mentoanterior
Left mentoposterior
Mentoposterior
Mentoanterior
Left mentotransverse
Right mentotransverse
LMA
RMP
RMA
LMP
MP
MA
LMT
RMT
Transverse Presentation (point of
designation— scapula of
presenting shoulder)
Left acromiodorso-anterior
Right acromiodorso-posterior
Right acromiodorso-anterior
Left acromiodorso-posterior
LADA
RADP
RADA
LADP
shortening of ligaments and tendons
caused by abnormal muscle tone (e.g., in
patients with injuries or burns).
axial p. A radiographical examination
position in which an image is obtained
with the central ray entering the body
at an angle.
Bonnet’s p. In inflammation of the
hip joint, the flexion, abduction, and
outward rotation of the thigh, which
produces relief.
Brickner p. A method of obtaining
traction, abduction, and external rotation of the shoulder by securing the patient’s wrist to the head of the bed.
centric p. The most posterior position
of the mandible in relation to the maxilla.
closed-packed p. The joint position in
which there is maximum congruency of
the articular surfaces and joint stability
is derived from the alignment of bones.
This is the opposite of the maximum
loose-packed position.
decubitus p. The position of the pa-
position
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tient on a flat surface. The exact position is indicated by which surface of the
body is closest to the flat surface (i.e., in
left or right lateral decubitus, the patient is flat on the left or right side, respectively; in dorsal or ventral decubitus, the patient is on the back or
abdomen, respectively).
dorsal p. A position in which the patient lies on the back. SYN: supine.
dorsal elevated p. A position in which
the patient lies on the back with the
head and shoulders elevated at an angle
of 30⬚ or more. It is employed in digital
examination of genitalia and in bimanual examination of the vagina.
dorsal recumbent p. A position in
which the patient lies on the back with
the lower extremities moderately flexed
and rotated outward. It is employed in
the application of obstetrical forceps, repair of lesions following parturition,
vaginal examination, and bimanual palpation. SEE: illus.
dorsosacral p. Lithotomy position.
SEE: dorsal recumbent p. for illus.
Edebohls’ p. Simon’s position.
Elliot’s p. A position in which supports are placed under the small of the
patient’s back so that the patient is in a
posture resembling a double inclined
plane.
English p. Left lateral recumbent position.
fetal p. The relationship of a specified
bony landmark on the fetal presenting
part to the quadrants of the maternal
pelvis.
Fowler’s p. SEE: Fowler’s position.
genucubital p. A position with the patient on the knees, thighs upright, body
resting on elbows, head down on hands.
Employed when it is not possible to use
the classic knee-chest position. SYN:
knee-elbow position.
genupectoral p. A position with the
patient on the knees, thighs upright, the
head and upper part of the chest resting
on the table, arms crossed above the
head. It is employed in displacement of
a prolapsed fundus, dislodgment of the
impacted head of a fetus, management
of transverse presentation, replacement
of a retroverted uterus or displaced
ovary, or flushing of the intestinal canal. SYN: knee-chest position. SEE: dorsal recumbent p. for illus.
gravity-dependent p. Placing a limb
so that its distal end is lower than the
level of the heart. Gravity affects the
fluids within the limb, drawing or retaining them to the distal aspect. When
limbs, esp. injured limbs, are placed below the level of the heart, interstitial
pressure is increased, encouraging the
formation and retention of edema
within the extremity.
head-down p. Trendelenburg position.
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position
1854
position
top of rh
base of rh
PRONE
FOWLER’S
SIMS’
KNEE-CHEST
LATERAL
STANDING
LATERAL RECUMBENT
SUPINE
POSITIONS
horizontal p. A position in which the
patient lies supine with feet extended.
It is used in palpation, in auscultation
of fetal heart, and in operative procedures.
horizontal abdominal p. A position in
which the patient lies flat on the abdomen, feet extended; employed in examination of the back and spinal column.
jackknife p. A position in which the
patient lies on the back, shoulders ele-
vated, legs flexed on thighs, thighs at
right angles to the abdomen. It is employed when introducing a urethral
sound. SYN: reclining position.
knee-chest p. Genupectoral position.
knee-elbow p. Genucubital position.
lateral p. In radiology, a side-lying position, which allows the central ray to
enter the upright side.
laterosemiprone p. SEE: Sims’ position.
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position
1855
lawn-chair p. A colloquial term for a
dorsal recumbent position with the hips
and knees flexed slightly (about 5⬚– 10⬚).
left lateral recumbent p. A position
with the patient on the left side, right
knee and thigh drawn up; employed in
vaginal examination. SYN: obstetrical
position.
lithotomy p. A position in which the
patient lies on the back, thighs flexed on
the abdomen, legs on thighs, thighs abducted. This is used in genital tract operations, vaginal hysterectomy, and the
diagnosis and treatment of diseases of
the urethra and bladder. SYN: dorsosacral position. SEE: dorsal recumbent
p. for illus.
loose-packed p. The position of a
joint where it is unlocked and free to
move. SEE: closed-packed p.
maximum loose-packed p. The position where maximum joint play occurs;
the position where ligaments and capsule have the least amount of tension.
This is also known as resting position.
Noble’s p. [Charles Percy Noble, U.S.
physician, 1863– 1935] A position in
which the patient is standing, leaning
forward, and supporting the upper body
by bracing the arms against the wall or
a chair. This position is useful in examining the kidney.
oblique p. In radiology, an alignment
of the body between a lateral and an
anteroposterior or posteroanterior position. The angle formed by the body
surface and the image receptor may
vary. The central ray enters the aspect
of the body that is upright and facing
away from the image receptor.
obstetrical p. Left lateral recumbent
position.
orthograde p. Anatomical position.
orthopneic p. The upright or nearly
upright position of the upper trunk of a
patient in a bed or chair. It facilitates
breathing in those with congestive
heart failure and some forms of pulmonary disease.
physiological rest p. In dentistry, the
position of the mandible at rest when
the patient is sitting upright and the
condyles are in an unstrained position.
The jaw muscles are relaxed. SYN: rest
position.
posterior-anterior p. ABBR: PA position. In radiology, a position in which
the central ray enters the posterior surface of the body and exits the anterior
surface.
prone p. A position in which the patient is lying face downward. SEE: dorsal recumbent p. for illus.
prone on elbows p. ABBR: POE. A
position in which the body is lying face
down with the upper trunk and head elevated, propped up by the arms, while
the lower body is in contact with the
supporting surface. The weight of the
positive
top of rh
base of rh
upper body rests on the elbows and forearms.
PATIENT CARE: This position, a component of the developmental sequence,
is used in physical therapy to improve
weight bearing and stability through
the shoulder girdle. Elbow joint stability is not required, because the joint is
not involved.
reclining p. Jackknife position.
rest p. Physiological rest position.
semi-Fowler’s p. A position in which
the patient lies on the back with the
trunk elevated at an approximate 30degree angle. SEE: Fowler’s position.
semiprone p. Sims’ position.
Sims’ p. SEE: Sims’ position.
subtalar neutral p. of the foot The
middle range of the subtalar joint with
no pronation or supination measured. It
is usually one third of the way from the
fully everted position.
tangential p. In radiology, a position
in which the central ray separates the
images of anatomical parts by skimming between them.
Trendelenburg p. SEE: Trendelenburg position.
tripod p. A position that may be assumed during respiratory distress to facilitate the use of respiratory accessory
muscles. The patient sits, leaning forward, with hands placed on the bed or a
table with arms braced.
unilateral recumbent p. The position
in which the patient lies on the right
side is used in acute pleurisy, lobar
pneumonia of the right side, and in a
greatly enlarged liver; the position in
which the patient lies on left side is used
in lobar pneumonia, pleurisy on the left
side, and in large pericardial effusions.
SEE: dorsal recumbent p. for illus.
Walcher’s p. SEE: Walcher’s position.
positioner (pō-zı̆sh⬘ŭn-ĕr) An apparatus
for holding or placing the body or body
part in a certain position.
positioning In rehabilitation, the placing
of the body and extremities so as to aid
treatment by inhibiting undesirable reflexes and preventing deformities. In
treatment of children with developmental disabilities involving neuromotor
function, the position of the body affects
the presence of some primitive reflexes
that can affect muscle tone. Alignment
of the head, neck, and trunk is therefore
thought to be important to reduce unnecessary influences on muscle tone,
and the careful placement of the limbs
is important to reduce or prevent contractions and deformities.
positive (pŏz⬘ı̆-tı̆v) [L. positivus, ruling]
1. Definite; affirmative; opposite of negative. 2. Indicating an abnormal condition in examination and diagnosis.
3. Having a value greater than zero. In
laboratory findings and mathematical
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positive predictive value
1856
expressions, positive is indicated by a
plus (⫹) sign.
positive predictive value The proportion
of people whose test results are “true”
positives and who are actually ill.
positron (pŏz⬘ı̆-trŏn) A particle having
the same mass as a negative electron
but possessing a positive charge.
Possum (pŏs⬘ŭm) [patient operated selector mechanism] A device that permits a person with a disability to control
and operate various machines such as
switches, telephones, and typewriters
by breathing into the master control of
the apparatus. SEE: environmental control unit.
post In dentistry, a cast restoration that
extends into the root of a tooth to anchor
a dental crown or prosthesis.
post- [L.] A prefix meaning behind, after, posterior.
postabortal (pōst⬙ă-bor⬘tăl) [L. post, behind, after, ⫹ abortus, abortion] Happening subsequent to abortion.
postadolescent (pōst⬙ăd-ō-lĕs⬘ĕnt) [⬙ ⫹
adolescens, to grow up] An individual
who has passed adolescence.
post-anesthesia care unit ABBR: PACU.
A unit to which patients are admitted
after surgery for the monitoring of signs
and symptoms that suggest that they
may have poorly tolerated their anesthesia or operation. The typical PACU
is staffed by nurses who evaluate patients for symptoms of instability (e.g.,
bleeding, chest pain, or labored
breathing), or unstable vital signs (e.g.,
excessive pain, low blood pressure, poor
oxygenation, or tachycardia). Anesthesiologists, hospitalists, and/or surgeons
may be available for consultation or the
management of emergencies.
postanesthesia recovery room nurse
(pōst-ăn-ĕs-thē-zhă) ABBR: PAR nurse.
A nurse who has received special training in caring for patients who have come
from surgery and are recovering from
the effects of anesthesia.
postanesthetic (pōst⬙ăn-ĕs-thĕt⬘ı̆k) [⬙ ⫹
Gr. an-, not, ⫹ aisthesis, sensation]
Pert. to the period following anesthesia.
postapoplectic (pōst⬙ăp-ō-plĕk⬘tı̆k) [⬙ ⫹
Gr. apoplessein, to cripple by a stroke]
Pert. to the period immediately following a stroke or apoplexy.
postbrachial (pōst⬙brā⬘kē-ı̆l ) [⬙ ⫹ brachiolis, arm] Pert. to the posterior portion of the upper arm.
postcardiotomy (pōst-kăr⬙dē-ŏt⬘ō-mē) [⬙
⫹ ⬙ ⫹ tome, incision] The period after
open-heart surgery.
postcardiotomy syndrome Postpericardiotomy syndrome.
postcibal (pōst-sı̄⬘băl) [⬙ ⫹ cibum, food]
ABBR: pc. Occurring after meals.
postclimacteric
(pōst⬙klı̄-măk-tĕr⬘ı̆k,
−măk⬘tĕr-ı̆k) [⬙ ⫹ Gr. klimakter, rung
of a ladder] Occurring after menopause.
posteroparietal
top of rh
base of rh
postcoital (pōst-kō⬘ı̆t-ăl) [⬙ ⫹ coitio, a
coming together] Subsequent to sexual
intercourse.
postcoital test (pōst⬙kō-ı̆-tăl) [⬙ ⫹ ⬙]
Huhner test.
postconcussion syndrome (pōst⬙kănkŭsh⬘ăn) Traumatic brain injury.
postconnubial (pōst⬙kŏn-ū⬘bē-ăl) [⬙ ⫹
connubium, marriage] Occurring after
marriage.
postconvulsive (pōst⬙kŏn-vŭl⬘sı̆v) [⬙ ⫹
convulsus, pull violently] Occurring after a convulsion.
postcranial (pōst-krā’nē-ăl) Behind or
below the cranium; used to describe the
bones of the trunk and limbs.
postdiastolic (pōst⬙dı̄-ăs-tŏl⬘ı̆k) [⬙ ⫹
Gr. diastole, expansion] Occurring after the cardiac diastole.
postdicrotic (pōst⬙dı̄-krŏt⬘ı̆k) [⬙ ⫹ Gr.
dikrotos, beating double] Occurring after the dicrotic pulse wave.
p. wave A recoil or second wave (not
always present) in a blood pressure
tracing.
postdiphtheritic (pōst⬙dı̆f-thĕr-ı̆t⬘ı̆k) Following diphtheria.
postencephalitis (pōst⬙ĕn-sĕf-ă-lı̄⬘tı̆s) [⬙
⫹ Gr. enkephalos, brain, ⫹ itis, inflammation] Occurring after encephalitis; an abnormal state remaining after
the acute stage of encephalitis has
passed.
postepileptic (pōst⬙ĕp-ı̆-lĕp⬘tı̆k) [⬙ ⫹
Gr. epi, upon, ⫹ lepsis, a seizure] Following an epileptic seizure. SEE: postictal.
posterior (pŏs-tē⬘rē-or) [L. comparative
of posterus, coming after] 1. In quadrupeds, pert. to or located at or toward
the rear of the body; caudal; opposite of
anterior. 2. In human anatomy, pert. to
or located at or toward the back; dorsal.
In human anatomy, “caudal,” “dorsal,”
and “posterior” mean the same thing.
3. Situated behind; coming after.
posterior teeth The bicuspid and molar
teeth.
posterior vitreous detachment ABBR:
PVD. Separation of the vitreous gel
from the retinal surface, often as a result of aging or diabetes mellitus.
postero- (pŏs⬘tĕr-ō) [L.] Prefix indicating posterior, situated behind, toward
the back.
posteroanterior
(pŏs⬙tĕr-ō-ăn-tēr⬘ē-or)
[L. posterus, behind, ⫹ anterior, anterior] Indicating the flow or movement
from back to front.
posterolateral (pŏs-tĕr-ō-lă⬘tĕr-ăl) [⬙ ⫹
lateralis, side] Located behind and at
the side of a part.
posteromedial (pŏs⬙tĕr-ō-mē⬘dē-ăl) [⬙ ⫹
medius, middle] Toward the back and
toward the median plane.
posteroparietal (pŏs⬙tĕr-ō-pă-rı̄⬘ĕ-tăl) [⬙
⫹ paries, a wall] Located at the back
of the parietal bone.
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posterosuperior
1857
posterosuperior
(pŏs⬙tĕr-ō-sū-pē⬘rē-or)
[⬙ ⫹ superior, upper] Located behind
and above a part.
posterotemporal (pŏs⬙tĕr-ō-tĕm⬘pō-răl)
[⬙ ⫹ temporalis, temporal] Located at
the back of the temporal bone.
posteruption (pōst⬙ĕr-ŭp-shŭn) Referring to the stage of tooth eruption in
which the tooth has reached the occlusal
plane and is functional, but continues to
erupt to compensate for loss of tooth
substance because of wear. SEE: eruption; pre-eruption.
postesophageal (pōst⬙ē-sŏf⬙ă-jē⬘ăl) [L.
post, behind, after, ⫹ Gr. oisophagos,
gullet] Located behind the esophagus.
postexposure (pōst⬙ĕx-pō⬘zhĕr) [⬙ ⫹ ⬙]
The period following actual or potential
contact with a pathogen or a toxic agent.
SEE: exposure.
postfall syndrome The inability to stand
or walk without support for fear of repeating a fall. It is not associated with
any physical disability and usually occurs in the elderly.
postfebrile (pōst-fē⬘brı̆l) [⬙ ⫹ febris, fever] Occurring after a fever.
postganglionic (pōst⬙găn-glē-ŏn⬘ı̆k) [⬙
⫹ Gr. ganglion, knot] Situated posterior or distal to a ganglion.
postgraduate year one ABBR: PGY-1.
The first year of graduate training after
completion of the formal 4 yr of medical
school. Previously, this year was known
as the internship year. Similarly, PGY2 and PGY-3 are the abbreviations for
postgraduate year two and three.
posthemiplegic (pōst⬙hĕm-ı̆-plē⬘jı̆k) [⬙
⫹ Gr. hemi, half, ⫹ plege, a stroke]
Occurring after hemiplegia.
posthemorrhagic (pōst-hĕm⬙ō-răj⬘ı̆k) [⬙
⫹ Gr. haima, blood, ⫹ rhegnynai, to
burst forth] Occurring after hemorrhage.
posthepatic Originating after bile leaves
the liver, as in posthepatic jaundice, in
which obstruction of bile ducts causes
the jaundice.
posthepatitic (pōst⬙hĕp-ă-tı̆t⬘ı̆k) [⬙ ⫹
Gr. hepar, liver, ⫹ itis, inflammation]
Occurring after hepatitis.
posthioplasty (pŏs⬘thē-ō-plăs⬙tē) [⬙ ⫹
plastos, formed] Plastic surgery of the
prepuce or foreskin.
posthitis (pŏs-thı̄⬘tı̆s) [⬙ ⫹ itis, inflammation] Inflammation of the foreskin.
SYN: acroposthitis.
post hoc (pōst hŏk) [L., “after this”] After the fact.
posthumous (pŏs⬘tū-mŭs) [L. postumus,
last] 1. Occurring after death. 2. Born
after the death of the father. 3. Said of
a child taken by cesarean section after
the death of the mother.
posthypnotic (pōst⬙hı̆p-nŏt⬘ı̆k) [L. post,
behind, after, ⫹ Gr. hypnos, sleep]
Occurring or performed after hypnosis.
p. suggestion SEE: under suggestion.
postmyocardial infarction
syndrome
top of rh
base of rh
posthypoxia syndrome (pōst⬙hı̆-pŏk⬘sēă) Hypoxic encephalopathy. SEE: hypoxia.
postictal (pōst-ı̆k⬘tăl) [⬙ ⫹ ictus, a blow
or stroke] Occurring after a sudden attack or stroke, as an epileptic seizure or
apoplexy.
p. confusion Confusion that follows
a seizure. It usually resolves in an hour
unless complicated by head injury, hypoxia, or status epilepticus. SEE: epilepsy.
posticteric (pōst⬙ı̆k-tĕr⬘ı̆k) [⬙ ⫹ Gr.
ikteros, jaundice] Occurring after jaundice.
postlingual (pŏst⬙lı̆ng⬘gwı̆l) [⬙⫹ ⬙] Occurring after the development and use
of speech and language.
postmalarial (pōst⬙mă-lā⬘rē-ăl) [⬙ ⫹ It.
malaria, bad air] Occurring after malaria.
postmature (pōst⬙mă-tūr⬘) [⬙ ⫹ maturus, ripe] Pert. to an infant born after
an estimated 42 weeks’ gestation, who
exhibits findings consistent with postmaturity syndrome.
postmaturity (pōst⬙mă-chŭr-ı̆-tē⬙) SEE:
postmaturity syndrome.
postmaturity syndrome (pŏst⬙ mā-chŭrı̆-tē) A condition occurring in infants
born after 42 weeks’ gestation who exhibit signs of perinatal compromise related to diminished intrauterine oxygenation and nutrition secondary to
placental insufficiency. During labor the
fetal monitor may display late decelerations, and fetal hypoxia may result in
meconium expulsion and aspiration.
Characteristic assessment findings include skin desquamation and an absence of lanugo and vernix caseosa.
Laboratory findings may include polycythemia and hypoglycemia. Postmature infants may also be at increased
risk of cold stress due to diminished
subcutaneous fat.
postmenopausal
(pōst⬙mĕn-ō-paw⬘zăl)
[⬙ ⫹ Gr. men, month, ⫹ pausis, cessation] Occurring after permanent cessation of menstruation.
postmenopause (pōst⬙mĕn⬘ō-pawz⬙) [⬙
⫹ ⬙] The phase of a woman’s life that
begins 1 year after her final menstrual
period.
postmortem (pōst⬘mŏr-tĕm) [L.] 1. Occurring or performed after death. 2. Autopsy.
postmyocardial
infarction
syndrome
(pōst-mı̄-ō-kăr⬘dē-ăl)
Nonischemic
chest pain occurring after a patient has
had a myocardial infarction, that typically worsens with deep breathing, improves while sitting up, and is aggravated by lying down. The patient may
develop a low-grade fever, an elevated
erythrocyte sedimentation rate, and elevated levels of antimyocardial antibodies. The cause is unknown. Patients
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postnasal
1858
usually are treated with nonsteroidal
anti-inflammatory drugs or corticosteroids. A similar syndrome occurs in
some patients who have undergone cardiac surgery (postpericardiotomy syndrome). SEE: Dressler’s syndrome.
postnasal (pōst-nā⬘zăl) [L. post, behind,
after, ⫹ nasus, nose] Located behind
the nasal cavities.
postnasal drip syndrome ABBR: PNDS.
An important cause of chronic cough, often associated with chronic or allergic
rhinitis, in which nasal secretions drain
via the posterior pharynx.
postnatal (pōst⬘nā⬘tăl) [⬙ ⫹ natus,
birth] Occurring after birth.
postnecrotic (pōst⬙nĕ-krŏt⬘ı̆k) [⬙ ⫹ Gr.
nekros, corpse] Occurring after the
death of a tissue or a part.
postneuritic (pōst⬙nū-rı̆t⬘ı̆k) [⬙ ⫹ Gr.
neuron, nerve, ⫹ itis, inflammation]
Occurring after neuritis.
postoperative (pōst⬙ŏp⬘ĕr-ă-tı̆v) [⬙ ⫹ ⬙]
After a surgery or any other invasive
procedure.
postoperative period The first hours and
days after surgery.
PATIENT CARE: During this period
patients often experience considerable
pain, difficulty in moving, nausea, vomiting, and changes in nutritional status
and fluid balance. Patients may also be
placed at risk of infection from the surgical wound and indwelling catheters.
Other high-risk possibilities after surgery include heart attack, atelectasis/
pneumonia, stroke, delirium, bleeding, clotting, adverse reactions to
medications, peptic ulceration, and
depression.
postparalytic (pōst⬙păr-ă-lı̆t⬘ı̆k) [⬙ ⫹
para, beside, ⫹ lyein, to loosen] Subsequent to an attack of paralysis.
postpartal period, postpartum period
(pōst-păr⬘tăl) Pert. to the 6-week period after childbirth, during which progressive physiological changes restore
uterine size and system functions to
nonpregnant status. SEE: Nursing Diagnoses Appendix.
postpartum (pōst-păr⬘tŭm) [L. post, after, ⫹ partus, birth] Occurring after
childbirth.
p. blues A period of heightened maternal emotions that follow the birth of
a baby, typically beginning in the first
three to five days after childbirth. Common symptoms are irritability, emotional lability, and tearfulness, although exaggerated happiness may also
be reported. Unlike postpartum depression (a persistent mood disturbance after childbearing), postpartum blues typically resolves in a week to ten days.
p. depression SEE: depression, postpartum.
p. pituitary necrosis Sheehan’s syndrome.
postpericardiotomy
postscarlatinal
top of rh
base of rh
syndrome
(pŏst⬙kăr-dē-ŏt⬘ŭ-mē) Fever, pericardial friction rub, and chest pain occurring several days or weeks after cardiac
surgery. The syndrome appears to be an
autoimmune response to damaged cardiac cells. Congestive heart failure may
ensue. SYN: postcardiotomy syndrome.
SEE: postmyocardial infarction syndrome.
postphlebitic Occurring after a blood clot
forms in a vein.
postphlebitic syndrome Pain and swelling felt in a limb that has been affected
by a blood clot in its deep veins (a deep
venous thrombosis). It is usually relieved somewhat by elevating the limb
and worsened when the limb is dependent.
postpneumonic (pōst⬙nū-mŏn⬘ı̆k) [⬙ ⫹
Gr. pneumon, lung] Occurring after
pneumonia.
postpolio syndrome (pōst-pō-lē-ō) The
development of motor and respiratory
muscle weakness, limb muscle atrophy,
fatigue, and diminished endurance occurring approx. 15– 25 years after an
initial bout of paralytic poliomyelitis.
The syndrome results from progressive
motor denervation.
PATIENT CARE: Affected patients
benefit from the use of mobility aids,
regular, supervised exercise, modifications of their homes and workplaces,
planned rest periods, and orthoses to
maintain optimal function and prevent
excessive fatigue and bone, joint, or
muscle injury. Patients with dysphagia
are at risk for aspiration pneumonia,
and benefit from speech consultation.
postprandial (pōst-prăn⬘dē-ăl) Following a meal.
p. dumping syndrome Dumping
syndrome.
postprandial reactive hypoglycemia, reactive hypoglycemia A low blood glucose level (⬍50 mg/dl or 3.3 mmol/L)
that occurs after a meal. It may result
from excessive treatment with insulin
or oral hypoglycemic drugs, from dumping syndrome or other digestive diseases, or from less common illnesses. It
may be managed with alpha-glucosidase inhibitors and changes in diet.
postpuberty (pōst-pū⬘bĕr-tē) [⬙ ⫹ pubertas, puberty] The period after puberty. postpubertal (−tăl), adj.
postpubescent (pōst⬙pū-bĕs⬘ĕnt) [⬙ ⫹
pubescens, becoming hairy] Following
puberty.
postradiation (pōst⬙rā-dē-ā⬘shŭn) Occurring after exposure to ionizing radiation.
postscapular (pōst-skăp⬘ū-lăr) [⬙ ⫹
scapula, shoulder blade] Infraspinous.
postscarlatinal (pōst⬙skăr-lă-tı̄⬘năl) [⬙ ⫹
scarlatina, scarlet fever] Following
scarlet fever.
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postsphygmic
1859
postsphygmic (pōst-sfı̆g⬘mı̆k) [⬙ ⫹ Gr.
sphygmos, pulse] Following the pulse
wave.
poststenotic (pōst⬙stĕ-nŏt⬘ı̆k) [⬙ ⫹ Gr.
stenosis, act of narrowing] Distal to a
stenosed or constricted area, esp. of an
artery.
postsynaptic (pōst⬙sı̆-năp⬘tı̆k) [⬙ ⫹ Gr.
synapsis, point of contact] Located distal to a synapse.
post-tachycardia syndrome Secondary
ST and T wave changes associated with
decreased filling of the coronary arteries
and subsequent ischemia during tachycardia.
post-tarsal (pōst-tăr⬘săl) [⬙ ⫹ Gr. tarsos, a broad, flat surface] Behind the
tarsus.
post-term pregnancy (pōst-tĕrm) Pregnancy continuing beyond the beginning
of the 42nd week (294 days) of gestation,
as counted from the first day of the last
normal menstrual period. This occurs in
an estimated 3% to 12% of pregnancies.
Complications include oligohydramnios, meconium passage, macrosomatia,
and dysmaturity, all of which may lead
to poor pregnancy outcome. The fetus
should be delivered if any sign of fetal
distress is detected. SEE: syndrome,
postmaturity.
post-tibial (pōst-tı̆b⬘ē-ăl) [⬙ ⫹ tibia,
shinbone] Behind the tibia.
post-transfusion purpura ABBR: PTP.
An abnormal, immune-mediated fall
in the number of circulating platelets,
caused by a recipient’s reaction to foreign antigens on platelets he or she
has received during a transfusion. Although the immune reaction normally
starts against the donated platelets,
in PTP host (recipient) platelets are
also attacked, leading to a severe decrease in platelet numbers about a
week, plus or minus 2 days, after the
platelet transfusion. The consequences
of a low platelet count may include
bleeding, bruising, or discoloration of
the skin.
post-transfusion syndrome (pōst-trănzfū-zhŭn) The development of fever,
splenomegaly, atypical lymphocytosis,
abnormal liver function tests, and, occasionally, a skin rash that develops following blood transfusion or perfusion of
an organ during surgery. The syndrome
appears 3 to 5 weeks after transfusion
or perfusion with fresh (less than 24 hr
old) blood, usually in large quantities.
The causative agent is thought to be cytomegalovirus.
post-traumatic (pōst⬙traw-măt⬘ı̆k) [⬙ ⫹
Gr. traumatikos, traumatic] Following
an injury or traumatic event.
post-traumatic stress disorder ABBR:
PTSD. Intense psychological distress,
marked by horrifying memories, recurring fears, and feelings of helplessness
postural hypotension
that develop after a psychologically
traumatic event, such as the experience
of combat, criminal assault, life-threatening accidents, natural disasters, or
rape. The symptoms of PTSD may include re-experiencing the traumatic
event (a phenomenon called “flashback”); avoiding stimuli associated with
the trauma; memory disturbances; psychological or social withdrawal; or increased aggressiveness, irritability, insomnia,
startle
responses,
and
vigilance. The symptoms may last for
years after the event, but often can be
managed with supportive psychotherapy or medications such as antidepressants.
post-traumatic syndrome A sustained
maladaptive response to a traumatic,
overwhelming event. SEE: Nursing Diagnoses Appendix.
postulate (pŏs⬘tū-lāt) [L. postulare, to
request] A supposition or view, usually
self-evident, that is assumed without
proof. SEE: Koch’s postulate.
postural (pŏs⬘tū-răl) [L. postura, position] Pert. to or affected by posture.
postural control An involuntary neurological loop consisting of motor, sensory,
and integrative processes used to
maintain the body’s position relative
to gravity and of its segments relative
to each other for stability. Postural
control relies on information from the
vestibular and somatosensory systems and visual cues. Balance is a
hallmark of postural control. SEE: balance; proprioception.
postural drainage A passive airway
clearance technique in which patients
are positioned so that gravity will assist the removal of secretions from
specific lobes of the lung, bronchi, or
lung cavities. It can be used for patients with pneumonia, chronic bronchitis, cystic fibrosis, bronchiectasis,
inhaled foreign bodies, before surgery
for lobectomy, or in any patient having difficulty with retained secretions.
A side effect of the treatment in some
patients is gastroesophageal reflux.
SEE: illus.
PATIENT CARE: Physical tolerance to
the procedure is evaluated. The respiratory therapist teaches and assists the
patient in the procedure, as ordered, by
positioning the patient for effective
drainage of the affected lung region(s).
The patient is encouraged to remove secretions with an effective cough. To decrease the risk of aspiration, the patient
should not perform the procedure after
meals. Chest vibration and percussion
are often performed at the same time to
assist movement of retained secretions
in the lung.
postural hypotension Orthostatic hypotension.
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postural orthostatic tachycardia
syndrome
posture
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tion. It is thought to be one of the dysautonomic syndromes.
posture (pŏs⬘chŭr) [L. postura] Attitude
or position of the body.
coiled p. Posture in which the body
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DRAINAGE OF UPPER LOBES
RIGHT AND LEFT
APICAL SEGMENTS
RIGHT AND LEFT
ANTERIOR SEGMENTS
RIGHT AND LEFT
LEFT
POSTERIOR SEGMENTS
POSTERIOR SEGMENTS
RIGHT
DRAINAGE OF MIDDLE LOBES
LINGULAR
RIGHT
DRAINAGE OF LOWER LOBES
SUPERIOR SEGMENTS
RIGHT AND LEFT
POSTURAL DRAINAGE OF LUNGS
postural orthostatic tachycardia syndrome ABBR: POTS. Inability to tolerate a standing position as a result of
a sudden increase in heart rate when
rising from a seated or recumbent posi-
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1861
posture
postviral fatigue syndrome
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DRAINAGE OF LOWER LOBES
BASAL SEGMENTS
RIGHT AND LEFT
ANTERIOR
RIGHT AND LEFT POSTERIOR
BASAL SEGMENTS
LATERAL SEGMENTS
LEFT
RIGHT
LATERAL SEGMENTS
POSTURAL DRAINAGE OF LUNGS
(CONTINUED)
is on one side with legs drawn up to
meet the trunk. It is used sometimes
during lumbar punctures.
dorsal rigid p. Posture in which the
patient lies on the back with both legs
drawn up. This is a position that is
maintained by some patients suffering
the pain of peritonitis.
hyperlordotic p. Increased lumbar
lordosis without compensation in the
thoracic or cervical spine. It is a component of the condition colloquially referred to as sway-back. SEE: illus.
kyphosis-lordosis p. A stance in
which the pelvis is tilted forward, causing hip flexion, increased lumbar lordosis, and thoracic kyphosis.
modified plantigrade p. A standing
position with the lower extremities on
the ground and the upper extremities
bearing weight on a table or other surface. The body weight is stabilized on all
four extremities. This posture is used
developmentally and in physical therapy to prepare for independent standing
and gait.
orthopnea p. Posture in which the
patient sits upright, hands or elbows
resting upon some support; seen in
asthma, emphysema, dyspnea, ascites,
effusions into the pleural and pericardial cavities, and congestive heart failure.
orthotonos p. Posture in which the
neck and trunk are extended rigidly in
a straight line; seen in tetanus, strychnine poisoning, rabies, and meningitis.
prone p. Prone.
semireclining p. Posture used instead of lying supine, by patients who
are short of breath, e.g., because of
heart failure.
standard p. The skeletal alignment
accepted as normal; used for evaluating
posture. There is equilibrium around
the line of gravity and the least amount
of stress and strain on supporting muscles, joints, and ligaments. From either
the front or the back, a plumb bob would
bisect the body equally. From the side,
a plumb bob would be anterior to the
lateral malleolus and the axis of the
knee, posterior to the axis of the hip and
the apex of the coronal suture, and
through the bodies of the lumbar vertebrae, the tip of the shoulder, the bodies of the cervical vertebrae, and the external auditory meatus.
swayback p. A relaxed stance in
which the pelvis is shifted forward, resulting in hip extension, and the thorax
is shifted backward, resulting in an increased thoracic kyphosis and forward
head. Also called slouched posture.
postvaccinal (pōst-văk⬘sı̆-năl) [⬙ ⫹ vaccinus, pert. to cows] Following vaccination; used esp. with reference to
safety issues or immune responses that
result from immunization.
postviral fatigue syndrome (pōst-vı̄-răl)
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post-void residual
1862
potassium
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Potain’s sign In dilatation of the aorta,
HYPERLORDOTIC POSTURE
Chronic disability following a presumed
viral infection. The most characteristic
and persistent feature of the disease is
muscle fatigue unrelieved by rest. Other
symptoms include low-grade fever,
headache, blurred vision or diplopia,
stiff neck, vertigo, nausea and vomiting,
lymphadenopathy, emotional lability,
insomnia, urinary frequency, and either
deafness or hyperacusis. In addition depression, anxiety, or other psychological
symptoms may be present. SYN: Royal
Free disease.
post-void residual Urine that remains in
the bladder after urination; e.g., in prostate hypertrophy.
potable (pō⬘tă-bl) [LL. potabilis] Suitable for drinking, esp. pert. to water free
of harmful organic or inorganic ingredients.
dullness on percussion over the area extending from the body of the sternum
toward the third costal cartilage on the
right, and to the base of the sternum.
potash (pŏt⬘ăsh) [Obsolete Dutch, potasschan] Potassium carbonate.
caustic p. Potassium hydroxide.
sulfurated p. A liver-colored or
green-yellow substance made up of potassium thiosulfate and potassium polysulfides and containing 12.8% sulfur as
a sulfide; a principal ingredient of white
lotion.
potassemia (pŏt-ă-sē⬘mē-ă) [NL. potassa, potash, ⫹ Gr. haima, blood]
Hyperkalemia.
potassium (pō-tăs⬘ē-ŭm) [NL. potassa,
potash] SYMB: K. A mineral element
that serves as both the principal cation
in intracellular fluid and an important
electrolyte in extracellular fluid. Along
with other electrolytes (e.g., sodium,
magnesium, calcium, chloride), potassium participates in many functions, including cell membrane homeostasis,
nerve impulse conduction, and muscle
contraction.
Potassium, which constitutes 0.35%
of body weight, is found in most foods,
including cereals, dried peas and beans,
fresh vegetables, fresh or dried fruits,
fruit juices, sunflower seeds, nuts, molasses, cocoa, and fresh fish, beef, ham,
or poultry. The usual dietary intake of
potassium is 50 to 150 mEq/day. In
healthy people, the kidneys excrete any
potassium excess consumed in the diet.
In patients with renal failure, congestive heart failure, hypertension, and
many other illnesses, serum potassium
levels must be adjusted carefully to
avoid adverse consequences of deficiency or excess.
DEFICIENCY: Muscle weakness, dizziness, thirst, confusion, changes in the
electrocardiogram, and life-threatening
arrhythmias may develop during potassium deficiency (hypokalemia).
EXCESS: Extracellular potassium is
increased in renal failure; in destruction
of cells with release of intracellular potassium in burns, crush injuries, or severe infection; in adrenal insufficiency;
in overtreatment with potassium salts;
and in metabolic acidosis. This causes
weakness and paralysis, impaired electrical conduction in the heart, and eventually ventricular fibrillation and death.
Hyperkalemia can be treated by withholding potassium, by using drugs such
as sodium polystyrene sulfonate, a cation exchange resin, to lower the potassium concentration in cells, and by using calcium gluconate to counteract the
effects on the heart.
Rapid infusion of potassium is
painful and may cause severe hy-
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potassium
1863
perkalemia, complicated by cardiac arrhythmias. Institutional protocols for the
use of intravenous potassium should be
followed carefully.
p. alum Aluminum potassium sulfate; strongly astringent, used topically
as a styptic. SEE: alum.
p. aminosalicylate Para-aminosalicylic acid.
p. carbonate K2CO3; a white crystalline powder used in pharmaceutical and
chemical preparations. SYN: potash.
p. chloride A mineral/electrolyte administered orally to treat and prevent
potassium depletion in patients who are
unable to digest adequate dietary potassium. It is also administered to treat
urinary tract infections and to prevent
kidney stones. Its therapeutic classes
are antiurolithics and mineral and electrolyte replacements/supplements.
p. chromate K2CrO4; lemon-yellow
crystals used as a dye and furniture
stain, in manufacture of batteries, in
photography, and in laboratories to preserve tissue.
p. citrate C6H5K3O7 · H2O; transparent prismatic crystals used as an alkalizer.
p. cyanide KCN; a highly poisonous
compound used as a fumigant.
p. gluconate C6H11KO7; a drug used
orally to replenish loss of potassium ion.
p. iodide KI; colorless or white crystals having a faint odor of iodine, used
as an expectorant. This form of potassium is recommended for use following
exposure to radioactive iodides downwind from a nuclear reactor accident.
The rationale is that it blocks the uptake of radioactive iodides by the thyroid gland, thus preventing or decreasing the chance of developing cancer of
the thyroid many years later.
p. permanganate KMnO4; crystals of
dark purple prisms that are sweet and
odorless. Concentrated solutions irritate and even corrode the skin and,
when swallowed, induce gastroenteritis. The solutions have considerable
power as disinfectants because their oxidizing ability destroys bacteria. They
fail to penetrate deeply in an active
form, which renders them of less value
than many other disinfectants, except
for use in very superficial infections.
total body p. SEE: total body potassium.
potassium chromate poisoning SEE:
under poisoning.
potato poisoning SEE: under poisoning.
potbelly (pŏt-bĕl-ē) Slang term for the
selective deposition of adipose tissue in
the abdominal subcutaneous tissue. It is
seen, e.g., in patients with the metabolic
syndrome (syndrome X).
potency (pō⬘tĕn-sē) [L. potentia, power]
potential
1. Strength; force; power. 2. Strength of
a medicine. 3. The ability of a man to
perform coitus.
potent (pō⬘tĕnt) [L. potens, powerful]
1. Powerful. 2. Highly effective medicinally. 3. Having the power of procreation.
potentia coeundi (pō-tĕn⬘shē-ă kō-ēŭn⬘dı̆) [L.] The ability to perform sexual intercourse in a normal manner.
potential (pō-tĕn-shăl) 1. Latent; existing in possibility. 2. In electricity, voltage or electrical pressure; a condition in
which a state of tension or pressure, capable of doing work, exists. When two
electrically charged bodies of different
potentials are brought together, an electric current passes from the body of high
potential to that of low.
action p. ABBR: AP. A local reversal
of the charge across an excitable cell
membrane that is propagated quickly
along the length of the membrane. In
humans, most of the cells that conduct
action potentials are neurons or muscles. As with all cells, neuron and muscle cell membranes actively maintain an
excess of negative ions inside the cell,
which gives them, at rest, a cross-membrane charge of about -75 to -80 mV. If
ion channels in one area of the membrane are caused to open briefly (as
when the membrane is stimulated by a
neurotransmitter), then charged ions
move across the membrane, reducing
the charge differential. When the crossmembrane charge reaches a threshold
level (often about -40 to -60 mV), sodium
ion channels (voltage-sensitive or voltage-gated channels) briefly open in the
vicinity. Sodium ions rush into the cell,
and temporarily the cross-membrane
potential rises to a peak of about ⫹40 to
⫹50 mV – the height of the action potential in that region. This flood of ions
also depolarizes adjacent membrane
regions, which quickly reach their
threshold levels, opening their voltagegated channels. In this way, the depolarization spreads rapidly along the
membrane.
after p. The small ionic changes
across an excitable membrane that follow an action potential.
demarcation p. The difference in potential between an intact longitudinal
surface and the injured end of a muscle
or nerve. SYN: injury potential.
injury p. Demarcation potential.
late p. Deflections found on signalaveraged electrocardiograms that follow the QRS complex, and point to an
increased likelihood of ventricular dysrhythmias. These deflections represent
delays in electrical conduction through
the ventricles.
liquid junction p. The potential voltage developed in an electrode measure-
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potential
1864
ment system at the point where two solutions are in contact. Most often the
solutions are the test solution and a liquid bridging solution such as saturated
KCl, although any liquid-liquid interface may be involved. An example is the
pH reference electrode.
membrane p. The electrical charge
or potential difference between the inside and outside of a cell membrane.
resting p. Polarization (3).
spike p. A change in potential that
occurs when a cell membrane is stimulated.
potentiate (pō-tĕn⬘shē-āt) To increase
the potency or action.
potentiation (pō-tĕn⬙shē-ā⬘shŭn) The
synergistic action of two substances,
such as hormones or drugs, in which the
total effects are greater than the sum of
the independent effects of the two substances.
potentiometer (pō-tĕn⬙shē-ŏm⬘ĕ-tĕr) A
voltmeter.
calibration p. A mechanically adjusted resistance used as a calibration
control on many instruments. It adjusts
a voltage or current within the device.
potion (pō⬘shŭn) [L. potio, draft] A
drink or draft; a dose of poison or liquid
medicine.
Pott, John Percivall (pŏt) British surgeon, 1714– 1788. He pioneered research into chemical carcinogenesis by
describing scrotal cancer in chimney
sweeps.
P.’s disease Infection of the vertebrae caused by miliary (disseminated)
tuberculosis. About 1% to 3% of patients
with tuberculosis have infections in the
bone; the spine is the most common site.
Organisms spread from the site of primary infection through the blood. Once
established in the spine, the infection
moves through the intervertebral disks
to multiple vertebrae. When it extends
into the surrounding soft tissue, abscesses may be created. SYN: spinal
caries; tuberculous spondylitis.
SYMPTOMS: Patients report pain
when they move their back. Signs include a low-grade fever, weight loss, and
local tenderness. When several upper
vertebrae are involved, compression
fractures, curvature of the spine (kyphosis), or nerve injury may occur.
TREATMENT: See Treatment section
under tuberculosis.
P.’s fracture Fracture of the lower
end of the fibula and medial malleolus
of the tibia, with dislocation of the foot
outward and backward.
P.’s paralysis Paralysis of the lower
half of the body due to vertebral infection with tuberculosis and subsequent
spinal cord injury SYN: Pott’s paraplegia.
pouch (powch) [ME. pouche] Any
pocket or sac.
povidone-iodine
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branchial p. Pharyngeal pouch.
colostomy p. A watertight receptacle that holds the discharge from a colostomy site. SYN: colostomy bag.
p. of Douglas Rectouterine pouch.
Heidenhain p. A small, surgically
constructed pouch of the stomach that
is denervated and separated from the
stomach and drained to the outside of
the body. It is used to study the physiology of the stomach.
hepatorenal p. Hepatorenal recess.
pharyngeal p. One of a series of five
pairs of entodermal outpocketings
that develop in lateral walls of the
pharynx of the embryo. SYN: branchial pouch.
rectouterine p. The pouch between
the anterior rectal wall and the posterior uterine wall. SYN: pouch of Douglas; cul-de-sac.
rectovesical p. A fold of peritoneum
that in men extends downward between
the bladder and rectum.
pouchitis (pŏw-chı̄⬘tı̆s) Acute or chronic
inflammation of the surgically produced
pouch used in restorative proctocolectomy.
poudrage (pū-drăzh⬘) [Fr.] Application
of an irritating, but otherwise nontoxic,
powder to the pleura to produce adhesions, e.g., in patients with recurring
pleural effusions.
poultice (pōl⬘tı̆s) [L. pultes, thick paste]
A hot, moist, usually medicated mass
that is placed between cloth sheets and
applied to the skin to relieve pain,
soothe injured tissues, stimulate the circulation, or act as a counterirritant.
SEE: plaster.
pound (pownd) [L. pondus, weight]
SYMB: lb. A measure of weight of the
avoirdupois and the apothecaries’ systems that is equal to 16 oz. SEE:
Weights and Measures Appendix.
avoirdupois p. Sixteen ounces, equal
to 453.59 g.
troy p. Twelve ounces, 5760 gr, equal
to 373.242 g.
poverty The condition of having an inadequate supply of money, resources, or
means of subsistence.
p. of thought The mental state of being devoid of thought and having a feeling of emptiness.
poverty level The relative standard of
living of individuals or families who
have inadequate funds to afford basic
needs, such as shelter, food, clothing, or
health care.
povidone (pō⬘vı̆-dōn) A synthetic polymer used as a dispersing and suspending agent in manufacturing drugs.
povidone-iodine A complex of iodine
with povidone. It contains not less than
9% and not more than 12% available iodine. This iodophor is used in dilute concentration as a surgical scrub, in aerosol
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1865
spray, in vaginal douche solutions, and
in ointments and gels.
Powassan virus (pō-wă⬘săn) [Powassan,
Canada] A rare flavivirus, transmitted
by tick bite, which occasionally causes
encephalitis.
powder [ME. poudre] 1. An aggregation
of fine particles of one or more substances that may be passed through fine
meshes. 2. A dose of such a powder, contained in a paper.
power [ME. power] 1. The rate at which
work is done; the work/time ratio. The
SI unit of power is the watt, equal to 1
joule per second. 2. The capacity for action. 3. In optics, the degree to which a
lens or optical instrument magnifies.
4. In microscopy, the number of times
the diameter of an object is magnified,
indicated by placing an ⫻ after the number (e.g., 10⫻ indicates magnification of
10 times). 5. In mathematics and in scientific nomenclature, the number of
times a value is to be multiplied by itself, the exponent (i.e., 102 ⫽ 10 ⫻ 10 ⫽
100; 103 ⫽ 10 ⫻ 10 ⫻ 10 ⫽ 1000). 6. In
statistics, the probability that a planned
investigation will yield a statistically
significant result. This is estimated by
calculating how many individuals need
to be randomly assigned to each group
studied and how many would have to
demonstrate improvement after receiving therapy in order to be able to conclude that one result meaningfully differs from another.
power, readiness for enhanced A pattern of participating knowingly in
change that is sufficient for well being
and can be strengthened. SEE: Nursing
Diagnoses Appendix.
power of attorney ABBR: POA. A legal
document by which a person identifies
someone to make financial decisions if
he or she is unable to perform this task
independently. SEE: power of attorney,
durable, for health care.
power of attorney, durable, for health
care An advance directive that designates another person to make health
care decisions regarding how aggressive
treatment should be if the patient becomes incompetent or unable to make
these decisions in the future, e.g., in
the case of coma or a persistent vegetative state. The document also lists
medical treatments that the person
would not want to have. Durable power
of attorney goes into effect when the
document is signed. The Patient SelfDetermination Act, enacted in 1991,
mandates the responsibility of health
care providers to develop written materials concerning advance directives.
Also called health care proxy. SEE: advance directive; living will.
powerlessness (pŏw⬘ĕr-lĕs-nĕs) 1. Lack
of control or influence. 2. The perception
of lacking control or influence on one’s
practice pattern
environment. SEE: helplessness; Nursing Diagnoses Appendix.
p., risk for At risk for perceived lack
of control over a situation and/or one’s
ability to significantly affect an outcome. SEE: Nursing Diagnoses Appendix.
pox (pŏks) [ME. pokkes, pits] 1. An
eruptive, contagious disease. 2. A papular eruption that becomes pustular.
SEE: chickenpox; smallpox.
poxvirus (pŏks⬘vı̄-rŭs) One of a group of
DNA viruses that produce characteristic spreading vesicular lesions, often
called pocks. It is the largest of the true
viruses and includes viruses responsible
for smallpox, vaccinia, molluscum contagiosum, and orf. SYN: pox virus.
pp punctum proximum, the near point of
accommodation (in vision).
ppb parts per billion.
PPD purified protein derivative.
PPE personal protective equipment.
ppm parts per million.
ppt parts per trillion; precipitate; prepared.
Pr 1. presbyopia. 2. Symbol for the element praseodymium.
pr L. punctum remotum, the far point of
visual accommodation.
PRA Panel reactive antibody
practice (prăk⬘tı̆s) [Gr. praxis, practice]
1. The use, by a health care professional, of knowledge and skill to provide
a service in the prevention, diagnosis,
and treatment of illness and in the
maintenance of health. 2. The continuing and repetitive effort to become proficient and to improve one’s skill in the
practice of medicine.
blocked p. A means of gaining mastery over a skill by drilling, i.e., by performing tasks or movements repeatedly
according to a fixed procedure.
evidence-based p. Evidence-based
health care.
patient safety p. A systematic health
care practice that reduces the likelihood
that patients will suffer undesirable
side effects from treatment.
random p. A means of gaining mastery over a skill through training exercises that vary the sequence of elements
in the skill. Compared with blocked
practice, in which a skill is learned by
fixed, repetitive drilling, random practice, with its frequently modified routine, results in better retention of the
skill after training is completed.
scope of p. The extent and limits of
the medical interventions that a health
care provider may perform.
practice guidelines Consensus statements by professional societies or
agents suggesting appropriate diagnostic and therapeutic options for patients
with a specified diagnosis.
practice pattern A preferred or standard
care method, esp. one about which au-
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practitioner
Prausnitz-Küstner reaction
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and pharmacists report their experience
to the United States Pharmacopeia,
12601 Twinbrook Parkway, Rockville,
MD 20852. The USP receives the reports and publishes the results. Drug
problem reports and medical device and
laboratory product problem reports may
be made by calling (800) 638-6725; medication errors may be reported by calling
(800) 23ERROR.
Prader-Willi syndrome (prah⬘ dĕr-vı̆l⬘ ē)
A rare inherited condition marked by
genetic obesity, hyperphagia, mental retardation, inadequate growth hormone
secretion, short stature, sexual infantilism, and hypotonia. The cause is an abnormal chromosome 15 of maternal origin. SEE: Angelman syndrome.
prae- SEE: pre-.
praecox (prē⬘kŏks) [L.] Early.
praevia, praevius (prē⬘vē-ă, prē⬘vē-ŭs)
[L.] Going before in time or place.
pragmatagnosia (prăg⬙măt-ăg-nō⬘zē-ă)
[Gr. pragma, object, ⫹ agnosia, lack of
recognition] Inability to recognize once
familiar objects.
pragmatamnesia (prăg⬙măt-ăm-nē⬘zē-ă)
[⬙ ⫹ amnesia, forgetfulness] The inability to recall the appearance of an object.
pragmatics (prăg-măt⬘ ı̆ks) In speech
and language pathology, the social or interpersonal context of language (i.e.,
knowing how to use spoken language
appropriately with other speakers).
pragmatism
(prăg⬘mă-tı̆zm)
[Gr.
pragma, a thing done, ⫹ −ismos, condition] The belief that the practical application of a principle should be the determining factor in decision making.
pragmatic (prăg-măt⬘ı̆k), adj.
pragmatist (prăg⬘mă-tı̆st) A person
whose goals are achieved or attempted
from a practical concept, action, or approach; a practical person.
pranayama (pră-nă-yă⬘mă) [Sanskrit
prana, life force ⫹ yama, self-control]
A pattern of regulated, rhythmic
breathing used in yoga and meditation
to clear the mind and relieve stress or
distraction. SYN: yogic breathing.
prandial (prăn⬘dē-ăl) [L. prandium,
breakfast] Relating to a meal.
praseodymium
(prā⬙sē-ō-dı̆m⬘ē-ŭm)
[Gr. prasios, leek-green, ⫹ didymium]
SYMB: Pr. A metallic element in the
rare earth series; atomic weight
140.907; atomic number 59.
Prausnitz-Küstner reaction (prows⬘nı̆tskı̆st⬘nĕr) [Carl Willi Prausnitz, Ger.
bacteriologist, 1876– 1963; Heinz Küstner, Ger. gynecologist, 1897– 1963] The
intracutaneous injection of a hypersensitive patient’s serum into a nonallergic
person followed, 24 to 48 hr later, by the
application of the suspected antigen to
the injection site. If a wheal and flare
occur, there is evidence that the suspected antigen is causing the hypersen-
short
standard
1866
thorities, experts, or experienced practitioners agree. Also called preferred
practice pattern.
practitioner (prăk-tı̆sh⬘ŭn-ĕr) One who
has met the professional and legal requirements necessary to provide a
health care service, such as a nurse,
dentist, dental hygientist, or physical
therapist.
acute care nurse p. A nurse who is
licensed to manage the care of select patient groups that have acute and specialized health care needs. The practice
of the acute care nurse practitioner may
be within a hospital setting or may extend into other areas of the community.
adult nurse p. ABBR: ANP. A nurse
practitioner who is licensed to treat people over 18 years of age.
advanced nurse p. An umbrella term
that includes the following health care
workers: Certified Midwife, Certified
Registered Nurse Anesthetist, Clinical
Nurse Specialist, and Nurse Practitioner.
emergency room p. A nurse certified
in the area of urgent care, who possesses skills in triage and the knowledge to meet the emergent needs of clients.
family nurse p. ABBR: FNP. A
nurse practitioner who is licensed to
treat people of any age. SEE: adult
nurse p.
geriatric nurse p. ABBR: GNP. An
advanced practice registered nurse with
a graduate specialty degree in the diagnosis, treatment, and management of
acute and chronic conditions commonly
found among older adults and generally
associated with aging. Generally GNPs
are required to have specialty certification by a nationally recognized credentialing organization. The functions of
the GNP are defined by individualized
scope of practice and collaborative
agreements with physicians and other
health-care providers based on state
nurse practice acts and experience, education, knowledge, and abilities. SYN:
gerontologic nurse practitioner.
gerontologic nurse p. Geriatric
nurse practitioner
mid-level p. Mid-level provider.
nurse p. SEE: under nurse.
pediatric nurse p. A certified nurse
who focuses on the common acute and
chronic illnesses experienced by children and adolescents. The pediatric
nurse practitioner integrates concepts
of growth and development in assessing
health care needs.
Practitioners’ Reporting Network, USP
ABBR: USP-PRN. Three separate programs designed to collect practitioners’
experience with unreliable drug products, defective medical devices, drug
problems with radiopharmaceuticals,
and medication errors. Practitioners
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Pravachol
1867
sitivity. Because of the danger of transmitting viral hepatitis and AIDS, this
test is no longer used.
Pravachol SEE: pravastatin.
pravastatin (pră⬘vă-stăt⬘ı̆n) An HMGCoA reductase inhibitor and lipid-lowering agent. It is administered orally, as
an adjunct to diet and exercise, to manage hypercholesterolemia and mixed
dyslipidemias.
praxiology (prăk⬙sē-ŏl⬘ō-jē) [⬙ ⫹ logos,
word, reason] The study of behavior.
praxis (prăk⬘sı̆s) [Gr., action] The ability to plan and execute coordinated
movement.
-praxis [Gr., action] Combining form indicating act, activity, practice, use.
PRBCs packed red blood cells.
pre- [L. prae, before] Prefix indicating
before, in front of. SEE: anti-; pro-.
preadmission certification Authorization granted to the patient for hospital
admission, after a review of the patient’s proposed need for inpatient services. In some settings, if predetermined criteria are not met, then the
admission is not allowed.
preagonal (prē-ăg⬘ō-năl) [L. prae, before, in front of, ⫹ Gr. agonia, agony]
Pert. to the condition immediately before death.
preandrogens (prē-ăn⬘drŭ-jĕn) [⬙ ⫹ ⬙]
Any biochemical precursors to male hormones. In women with polycystic ovaries, elevated levels of preandrogens
such as androstenedione and dehydroepiandrosterone (DHEA) are found in
the bloodstream. These steroid hormones are synthesized in the adrenal
glands; DHEA, DHEA sulfate, and androstenedione are converted in target
tissues (such as the prostate gland) into
dihydrotestosterone, which produces
masculinizing characteristics and stimulates the growth of prostate cancers.
Preandrogen levels fall as people age.
Decreases in preandrogens cause some
of the symptoms of perimenopause and
menopause.
preanesthesia (prē⬙ăn-ĕs-thē⬘zē-ă) A
light anesthesia produced by a medication given before anesthesia.
preanesthetic (prē⬙ăn-ĕs-thĕt⬘ı̆k) [⬙ ⫹
Gr. anaisthesia, lack of sensation] A
preliminary drug given to facilitate induction of general anesthesia. SYN: premedication (2).
preataxic (prē-ă-tăk⬘sı̆k) [⬙ ⫹ Gr.
ataxia, lack of order] Before the onset
of ataxia.
preauthorization (prē⬙ awth⬙ ĕr-ı̆-zā⬘
shŭn) The agreement of a health care
funding agent (e.g., a health maintenance organization, health insurer, or
governmental agency) to defray the
costs of a proposed treatment or procedure before its occurrence.
preaxial (prē-ăk⬘sē-ăl) [⬙ ⫹ Gr. axon,
preceptorship
top of rh
base of rh
axis] In front of the axis of a limb or of
the body.
prebiotic (prē-bı̄-ŏt⬘ı̆k) [⬙ ⫹ ⬙] A nutrient that stimulates the growth or health
of bacteria living in the large intestine.
Prebiotics are typically neither absorbed nor digested by the mammalian
gastrointestinal tract. Their effects on
human health occur indirectly, through
their promotion of commensal organisms in the colon.
precancer (prē⬘kăn-sĕr) [⬙ ⫹ cancer,
crab] A condition that tends to become
malignant.
precancerous (prē-kăn⬘sĕr-ŭs) [⬙ ⫹
cancer, crab] Pertaining to a growth
that is not yet, but probably will become, cancerous. SYN: premalignant.
precapillary (prē⬙ kăp⬘ ı̆-lĕr⬙ ē) [⬙ ⫹ capillaris, hairlike] Before or at the beginning of a capillary network, such as a
precapillary sphincter.
precaution (prı̆-kaw⬘ shŭn) An action
taken in advance to protect against danger, harm, or possible failure.
airborne p. Isolation, airborne.
contact p. Isolation, contact.
droplet p. Isolation, droplet.
precautionary principle, principle of precaution A risk management principle,
originally developed in the environmental movement, based on the concept of
avoiding any new action (e.g., introducing a new technology or a new drug) that
carries a hypothetical risk for human or
planetary health, regardless of whether
the hypothesis has been subjected to
formal testing.
precautions, blood and body fluid Universal precautions. SEE: Standard Precautions Appendix.
precautions, standard Guidelines recommended by the Centers for Disease
Control and Prevention to reduce the
risk of the spread of infection in hospitals. These precautions (e.g., handwashing and wearing personal protective
equipment such as gloves, mask, eye
protection, gown) apply to blood, all
body fluids, secretions, excretions (except sweat), nonintact skin, and mucous
membranes of all patients and are the
primary strategy for successful nosocomial infection control. SEE: Standard
Precautions Appendix.
precautions, universal SEE: Standard
Precautions Appendix.
precedent In law, an action, ruling, or
verdict that may be used as an example
to be followed in the future.
preceptor (prı̆-sep⬘tĕr, prē⬘sĕp-) [L.
praecipere, to direct] 1. A teacher or instructor. 2. An expert who supervises
and instructs students in clinical practice experiences, esp. medicine or nursing.
preceptorship (prı̆-sep⬘tĕr-shı̆p) A period of practical training under the su-
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
precipitant
prediabetes
top of rh
base of rh
tion that occurs before actual observation and treatment of patients.
preclinical dental training Study and
mastery of the theory and techniques
related to the various dental procedures
required prior to treating human patients.
preclinical technique In dentistry, the
use of manikins, mechanical articulator, artificial or extracted teeth, and the
variety of dental instruments and materials to study and master the techniques necessary to do clinical dentistry.
precocious (prē-kō⬘shŭs) [L. praecox,
ripening early] Achieving mental or
physical development earlier than expected.
precocity (prē-kŏs⬘ı̆-tē) Premature development of physical or mental traits.
sexual p. Onset of secondary sex
characteristics at an earlier age than expected, typically before age 6– 8 in girls
or 9 in boys. SEE: precocious puberty.
precognition (prē⬙kŏg-nı̆sh⬘ŭn) [L. prae,
before, in front of, ⫹ cognoscere, to
know] Prior knowledge that an event
will occur acquired pre-rationally.
precoital (prē-kō⬘ı̆-tăl) [⬙ ⫹ coitio, a going together] Prior to sexual intercourse.
precoma (prē-kō⬘mă) [⬙ ⫹ Gr. koma, a
deep sleep] An imprecise term for lethargy or stupor.
precondition (prē⬙kŭn-dı̆sh⬘ı̆n) [⬙ ⫹ ⬙]
To protect tissues from future injury
with anesthetics, drugs, physical exercises, or other therapies.
preconscious (prē-kŏn⬘shŭs) [⬙ ⫹ conscius, aware] Not present in consciousness but able to be recalled as desired.
preconvulsive (prē⬙kŏn-vŭl⬘sı̆v) [⬙ ⫹
convulsio, pulling together] Before a
convulsion.
precordia (prē-kor⬘dē-ă) [L. praecordia]
Plural of precordium.
precordial thump A sharp blow delivered
to the precordial area of the chest in an
attempt to terminate a lethal cardiac
rhythm, such as ventricular fibrillation
or ventricular tachycardia. SYN: chest
thump.
precordium (prē-kor⬘dē-ŭm, prē-kor⬘dēă) pl. precordia The area on the anterior
surface of the body overlying the heart
and lower part of the thorax. precordial
(prē-kor⬘dē-ăl), adj.
precursor (prē-kĕr⬘sĕr) A substance that
precedes another substance (e.g., in a
series of chemical reactions); or a substance from which another is synthesized.
predentin (prē-dĕn⬘tı̆n) Uncalcified dentinal matrix.
prediabetes (prē-dı̄⬙ă-bē⬘tēz) [⬙ ⫹ Gr.
diabetes, passing through] Early evidence either of autoimmune disease or
impaired carbohydrate metabolism in
patients who later develop overt diabe-
short
standard
1868
pervision of an experienced or certified
practitioner or specialist. SEE: preceptor.
precipitant (prē-sı̆p⬘ı̆-tănt) [L. praecipitare, to cast down] A substance bringing about precipitation.
precipitate (prē-sı̆p⬘ı̆-tāt) 1. A deposit
separated from a suspension or solution
by precipitation, the reaction of a reagent that causes the deposit to fall to
the bottom or float near the top. 2. To
separate as a precipitate. 3. Occurring
suddenly or unexpectedly.
precipitation
(prē-sı̆p⬙ı̆-tā⬘shŭn)
[L.
praecipitatio] 1. The process of a substance being separated from a solution
by the action of a reagent so that a precipitate forms. 2. The sudden and unprepared-for delivery of an infant. SEE:
precipitous delivery.
precipitation test A test in which a positive reaction is indicated by formation of
a precipitate in the solution being
tested.
precipitin (prē-sı̆p⬘ı̆-tı̆n) An antibody
formed in the serum of an animal owing
to the presence of a soluble antigen,
usually a protein. When added to a solution of the antigen, it brings about
precipitation. The injected protein is
called the antigen, and the antibody
produced is the precipitin. It was originally thought that these antibodies
were members of a unique class, but
most antibodies are capable of precipitating when combined with their antigens. SEE: autoprecipitin; precipitinogen.
precipitinogen (prē-sı̆p⬙ı̆-tı̆n⬘ō-jĕn) Any
protein that, acting as an antigen, stimulates the production of a specific precipitin.
precipitinoid (prĕ-sı̆p⬘ı̆t-ı̆n-oyd) A precipitin that can no longer cause precipitation when mixed with its antigen but
that retains its affinity to the antigen.
precipitin test A test in which two dissolved substances in a solution join to
form a visible solid. The results depend
on the strength of the attraction between the Fab fragment on the antibody
and the corresponding epitope on the
antigen (affinity) and on the stability of
the complex (antibody avidity). The test
demonstrates how immune complexes
form in the circulation and are deposited in blood vessel walls. SEE: precipitation test.
precipitophore (prē-sı̆p⬘ı̆t-ō-for⬙) The
part of a precipitin that produces the actual precipitation.
precipitum (prē-sı̆p⬘ı̆-tŭm) The precipitate produced by action of a precipitin.
preclinical (prē-klı̆n⬘ı̆-kăl) [L. prae, before, in front of, ⫹ Gr. klinike, medical
treatment in bed] 1. Occurring before
diagnosis of a definite disease is possible. 2. Classroom training and educa-
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
prediastole
1869
tes mellitus. The condition includes impaired fasting glucose and impaired glucose tolerance. In the U.S. in 2007 more
than 50 million people were affected by
prediabetes.
prediastole (prē⬙dı̄-ăs⬘tō-lē) [⬙ ⫹ Gr.
diastellein, to expand] The period in
the cardiac cycle just before diastole.
prediastolic, (prē⬙dı̄-ă-stŏl⬘ı̆k), adj.
predicrotic (prē⬙dı̄-krŏt⬘ı̆k) [⬙ ⫹ Gr.
dikrotos, beating double] Preceding the
dicrotic wave of the sphygmographic
tracing.
prediction rules Identifying and giving
weight to the factors important in formulating a diagnosis, in order to establish the probability that a disease is
present.
predigestion (prē⬙dı̆-jĕs⬘chŭn) [⬙ ⫹ digestio, carrying apart] Artificial proteolysis or digestion of proteins and amylolysis of starches before ingestion.
predisposing (prē⬙dı̆s-pōz⬘ı̆ng) [⬙ ⫹
disponere, to dispose] Indicating a tendency to, or susceptibility to, disease.
predisposition (prē⬙dı̆s-pō-zı̆sh⬘ŭn) The
potential to develop a certain disease or
condition in the presence of specific environmental stimuli.
prednisolone (prĕd-nı̆s⬘ō-lōn) A glucocorticosteroid drug, available in a variety of dosage forms. It is similar in action to cortisone.
prednisone (prĕd⬘nı̆-sōn) A glucocorticosteroid with the same effects as cortisone.
preeclampsia (prē⬙ĕ-klămp⬘sē-ă) [⬙ ⫹
Gr. ek, out, ⫹ lampein, to flash] A
complication occurring in about 3% to
5% of pregnancies, characterized by increasing hypertension, proteinuria, and
edema. The condition may progress rapidly from mild to severe and, if untreated, to eclampsia. It is the leading
cause of fetal and maternal morbidity
and death, esp. in underdeveloped countries. SEE: eclampsia; HELLP syndrome; pregnancy-induced hypertension; Nursing Diagnoses Appendix.
ETIOLOGY: The cause is unknown;
incidence is higher among adolescents,
in first pregnancies, in women who
smoke, and in women who are diabetic
or overweight. The disease mechanisms
found in pre-eclampsia include generalized vasospasm, damage to the glomerular membranes, and hypovolemia
and hemoconcentration due to a fluid
shift from intravascular to interstitial
compartments.
SYMPTOMS: The condition develops
between the 20th week of gestation and
the end of the first postpartum week; it
usually occurs during the last trimester.
Characteristic complaints include sudden weight gain, severe headaches, and
visual disturbances. Indications of increasing severity include complaints of
epigastric or abdominal pain; general-
preganglionic
ized, presacral, and facial edema; oliguria; and hyperreflexia. Objective findings include hypertension, edema,
proteinuria, and hyperreflexia. SEE: reflex, deep tendon.
TREATMENT: Treatment includes
bedrest, diet, drugs to manage high
blood pressure, intravenous magnesium
sulfate, or immediate delivery of the fetus, depending on the severity of the disease and the development of the fetus.
PROGNOSIS: A history of preeclampsia increases a woman’s likelihood of
vascular diseases (e.g., heart attacks
and strokes) later in life. Women with
preeclampsia should be monitored postpartum for elevated blood pressures,
blood sugars, and lipid levels. Cardiovascular risk factors should be treated
aggressively to prevent future atherosclerotic illness.
pre-embryo (prē⬙ ĕm⬘ brē-ō) The morula
and blastocyst stages produced by the
division of the zygote until the formation of the embryo proper at the appearance of the primitive streak about 14
days after fertilization.
pre-embryonic period (prē-ĕm⬙brē-ŏn⬘ı̆k)
In human gestation the stage of prenatal development beginning with implantation of the fertilized egg and ending at
day 4.
pre-eruption (prē⬙ē-rŭp⬘shŭn) [⬙ ⫹
eruptio, a breaking out] 1. Before an
eruption. 2. The stage of tooth eruption
when the tooth bud is in the bony socket
prior to root formation. SEE: eruptive
stage (2).
pre-excitation, ventricular (prē-ĕk⬙sı̄tā⬘shŭn) [⬙ ⫹ excitare, to arouse] Premature excitation of the ventricle by an
impulse that traveled a path other than
through the atrioventricular node. This
produces a short P-R interval. SEE:
Wolff-Parkinson-White syndrome.
pre-existing condition Any injury, disease, or physical condition occurring
prior to an arbitrary date; usually used
in reference to the date of issuance of a
health insurance policy. In some cases,
a pre-existing condition results in an exclusion from coverage for costs resulting
from the injury, disease, or condition.
preferred provider organization ABBR:
PPO. An incorporated group of physicians, hospital(s), nurses, and other
health care workers, who jointly assume
the clinical and financial responsibilities for delivering health care to enrolled groups of insured patients. The
providers are semi-independent agents
who agree to provide care at reduced
rates.
prefrontal (prē-frŏn⬘tăl) [⬙ ⫹ frons,
front] 1. The middle portion of the ethmoid bone. 2. In the anterior part of the
frontal lobe of the brain.
preganglionic (prē⬙găng-lē-ŏn⬘ı̆k) [⬙ ⫹
Gr. ganglion, knot] 1. Situated in front
top of rh
base of rh
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
preganglionic fiber
1870
of or anterior to a ganglion. 2. Situated
before a ganglion, such as a preganglionic neuron.
preganglionic fiber The axon of a preganglionic neuron.
pregenital (prē-jĕn⬘ı̆-tăl) [⬙ ⫹ genitalia,
genitals] In psychology, relating to that
period when erotic interest in the reproductive organs and functions is not yet
organized.
pregnancy (prĕg⬘năn-sē) [L. praegnans]
The condition of having a developing
embryo or fetus in the body after successful conception. The average duration of pregnancy is about 280 days. Estimation of the date on which delivery
should occur is based on the first day of
the last menstrual period. SEE: Naegeli’s rule; table; prenatal care; prenatal
diagnosis; Nursing Diagnoses Appendix.
DEMOGRAPHICS: About 7 million
Americans become pregnant each year,
and about two thirds of these pregnancies result in live births. In 2005, there
were 4,140,419 live births in the US.
SIGNS AND SYMPTOMS: Presumptive and probable signs are those commonly associated with pregnancy but
may be due to other causes, such as oral
contraceptive therapy. Presumptive
symptoms include amenorrhea, nausea
and vomiting, breast tenderness, urinary frequency, fatigue, chloasma, vaginal hyperemia (Chadwick’s sign), and
“quickening.” Probable signs include increased abdominal girth, palpable fetal
outline, softening of the lower uterine
segment (Hegar’s sign), softening of the
cervix (Goodell’s sign), and immunodiagnostic pregnancy tests. Positive signs
and symptoms of pregnancy are auscultation of fetal heart sounds, fetal movements felt by the examiner, and an
identifiable embryonic outline on ultrasound.
PHYSICAL CHANGES: The pregnant
woman experiences many physiological
alterations related to the increased levels of estrogen and progesterone and to
the demands of the growing fetus; every
system in the woman’s body responds to
these changes.
Reproductive tract changes: Alterations in uterine size, shape, and consistency include an increase in uterine muscle mass over the months of pregnancy.
In response to elevated estrogen and
progesterone levels, the cervix and
lower uterine segment soften. A thick
mucous plug fills the cervical canal.
Vaginal secretions increase, and vaginal pH is more acidic (pH ⫽ 3.5 to 6.0).
Change in vaginal pH discourages the
survival and multiplication of bacteria;
however, it also encourages infection by
Candida albicans. The vagina elongates
as the uterus rises in the pelvis; the mucosa thickens, with increases in secre-
pregnancy
top of rh
base of rh
tions, vascularity, and elasticity. SEE:
Chadwick’s sign; Goodell’s sign; Hegar’s
sign.
Breast changes: The breasts become
enlarged, tender, and more nodular.
The areolae darken; the nipples become
more sensitive and erectile; and Montgomery’s tubercles enlarge. Colostrum
may leak out during the last trimester,
as the breasts prepare for lactation.
Endocrine glands: The size and activity of the thyroid gland increase markedly. Thyroid-binding globulin and triiodothyronine levels rise, while thyroid
stimulating hormone levels drop
slightly. These changes allow the pregnant woman to meet the endocrine
needs imposed by the developing fetus,
and other body changes that occur during pregnancy. Pituitary activity increases; prolactin levels increase ensuring lactation; placental hormones
prevent ovulation and encourage development of the corpus luteum. Parathyroid activity decreases during the first
trimester, then increases throughout
the pregnancy to meet the increasing
calcium demands of the fetus. Insulin
resistance increases; this poses a risk,
for some women, of glucose intolerance
or gestational diabetes mellitus.
Cardiovascular alterations: Circulating blood volume increases progressively throughout pregnancy, peaking
in the middle of the third trimester. Although the red blood cell count rises by
about 30%, a 50% increase in blood volume creates dilutional anemia. The
lower relative hematocrit decreases
blood’s viscosity. However, a hemoglobin concentration of less than 11 g is
usually due to iron deficiency. Rising
levels of clotting factors VII, VIII, IX, X,
fibrinogen, and von Willebrand factor
increase coagulability. The pulse rate
increases, along with cardiac stroke volume. Peripheral vascular resistance
drops. Mid-trimester blood pressure
may be slightly lower than normal but
remains essentially unchanged.
Skeletal system: Softening and increased mobility of the pelvic articulations is reflected in the waddling gait of
pregnancy. As pregnancy progresses,
the woman’s center of gravity shifts,
and the lumbar curve increases to compensate for the growing anterior weight
of the gravid uterus. Problems with dental caries may become more prominent
during pregnancy but can be prevented
with oral rinses (such as chlorhexidine)
and regular brushing and flossing.
Respiratory system: The effects of progesterone on smooth muscle include a
decreased airway resistance, which enables the woman to meet her increased
needs for oxygen by permitting a 30% to
40% increase in tidal volume and a 15%
to 20% rise in oxygen consumption. The
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17
22
17
22
17
21
17
24
17
23
17
24
17
24
17
24
17
24
17
23
18
25
18
25
18
23
18
23
18
22
18
25
18
24
18
25
18
25
18
25
18
25
18
24
19
26
19
26
19
24
19
24
19
23
19
26
19
25
19
26
19
26
19
26
19
26
19
25
20
27
20
27
20
25
20
25
20
24
20
27
20
26
20
27
20
27
20
27
20
27
20
26
21
28
21
28
21
26
21
26
21
25
21
28
21
27
21
28
21
28
21
28
21
28
21
27
22
29
22
29
22
27
22
27
22
26
22
29
22
28
22
29
22
29
22
29
22
29
22
28
Pregnancy Table for Expected Date of Delivery
10
17
10
17
10
15
10
15
10
14
10
17
10
16
10
17
10
17
10
17
10
17
10
16
23
30
23
30
23
28
23
28
23
27
23
30
23
29
23
30
23
30
23
30
23
30
23
29
24
31
24
1
24
29
24
29
24
28
24
31
24
30
24
31
24
1
24
31
24
31
24
30
25
1
25
2
25
30
25
30
25
1
25
1
25
1
25
1
25
2
25
1
25
1
25
1
26
2
26
3
26
31
26
31
26
2
26
2
26
2
26
2
26
3
26
2
26
2
26
2
27
3
27
4
27
1
27
1
27
3
27
3
27
3
27
3
27
4
27
3
27
3
27
3
28
4
28
5
28
2
28
2
28
4
28
4
28
4
28
4
28
5
28
4
28
4
28
4
29
3
29
3
29
5
29
5
29
5
29
5
29
6
29
5
29
5
29
5
30
4
30
4
30
6
30
6
30
6
30
6
30
7
30
6
30
6
30
6
Sept.
31
7 Oct.
July
31
7 Aug.
April
31
7 May
31
7 June
Feb.
31
7 Mar.
Dec.
31
5 Jan.
29 30 31
5 6 7 Nov.
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The date of the last menstrual period is in the top line (light-face type) of the pair of lines. The dark number (bold-face type) in the line below will be the expected day
of delivery.
Jan.
Oct.
Feb.
Nov.
Mar.
Dec.
April
Jan.
May
Feb.
June
Mar.
July
April
Aug.
May
Sept.
June
Oct.
July
Nov.
Aug.
Dec.
Sept.
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effects of estrogen include edema and
congestion of the nasal mucosa, reflected in nosebleeds and nasal stuffiness.
Gastrointestinal system: Nausea and
vomiting is the single most common
complaint during the first trimester.
Progesterone-related diminished motility contributes to common complaints of
heartburn and constipation. Hemorrhoids are common and caused by increased pressure in the lower pelvis and
constipation.
Immune system Alterations in T
helper cell dominance produce immunological tolerance for the fetus and the
placenta, both of which contain antigens
that are alien to the mother. During
pregnancy, autoimmune diseases such
as rheumatoid arthritis or systemic lupus erythematosus tend to become less
active.
Skin: Pigmentation changes in pregnancy include chloasma (the so-called
mask of pregnancy), areolar darkening,
and linea nigra (a pigmented line that
vertically bisects the abdomen). They
reflect estrogen-related stimulation of
skin melanocytes. Striae gravidarum,
also called stretch marks, may appear
in the skin of the abdomen, breasts, and
thighs.
Urinary system: By middle of the first
trimester, the glomerular filtration rate
has risen by about 50%; in compensation, tubular reabsorption also increases. Although urinary frequency is
common in the first and last trimesters,
bladder capacity actually increases;
however, pressure from the growing
uterus reduces the volume required to
stimulate voiding. During the second
trimester, the uterus rises out of the pelvis, becoming an abdominal organ and
relieving bladder compression until late
in the third trimester.
Weight: In average-sized individuals,
expected first trimester weight gain is 2
to 5 lb. Total weight gain and the pattern by which it increases should be
monitored to enable early signs of pregnancy-related problems common to the
particular point in gestation. The Institute of Medicine recommends the following weight gains during singleton
pregnancies: a woman with a prepregnancy body mass index less than 19.8
should gain 25 to 39 lb (11.4 to 17.7 kg);
a woman with a prepregnancy body
mass index from 19.8 to 26 should gain
25 to 34 lb (11.4 to 15.5 kg); and a
woman with a prepregnancy body mass
index from 26 to 29 should gain 15 to 24
lb (6.8 to 10.9 kg). The recommended
weight gains during pregnancy are different for multiple gestations (e.g., a
woman carrying triplets should gain
about 50 lb [22.7 kg] during the course
of her pregnancy).
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PATIENT CARE: An essential component to anticipatory guidance and patient teaching is to encourage the
woman’s active participation in her own
health maintenance and pregnancy progress. Health care providers describe to
pregnant women common complaints
related to normal physiological changes
of pregnancy and suggest actions to
minimize discomfort.
DISORDERS: Nausea and vomiting.
SEE: morning sickness.
Heartburn: Hormone-related delayed
gastric emptying, cardiac sphincter relaxation, and stomach displacement by
the growing uterus contribute to reflux.
The use of low-sodium or combination
aluminum hydroxide/magnesium hydroxide preparations is recommended
for symptomatic relief. For severe, unresponsive heartburn, over-the-counter
H2 blockers, such as ranitidine (Zantac)
or famotidine (Pepcid), may be recommended.
Constipation: The woman should increase fiber and fluid intake. She also
may use stool softeners.
Muscle cramps: The woman may relieve the so-called “charleyhorse” that
occurs during sleep by dorsiflexing the
foot of the affected leg. A calcium-phosphorus imbalance may contribute to increased frequency of this problem, although the causes are not clear. The
woman can increase calcium intake by
drinking the recommended daily quart
of milk or by drinking a pint of milk
daily and taking a calcium supplement
with vitamin D.
Back pain: Growing anterior mass,
shift in center of gravity, and increased
lumbar curve contribute to backaches.
To relieve discomfort, the pregnant
woman should wear well-fitting, lowheeled shoes and perform exercises that
increase abdominal muscle tone. SEE:
pelvic rock; pelvic tilt.
Dependent edema: Pedal edema is a
common third-trimester complaint related to decreased venous return from
the extremities. The woman is advised
to rest frequently and to elevate her
feet. She should report promptly any
edema of the face, hands, or sacral area
to facilitate early diagnosis and management of pregnancy-induced hypertension.
Varicose veins: Decreased venous return from the extremities and compression of vascular structures by the growing uterus aggravate any weakness in
the vascular walls and valves. Varicosities often occur in the legs, vulva, and
pelvis. The woman should avoid tight
clothing and prolonged standing. Other
preventive and therapeutic measures
include wearing support stockings, resting in left Sims’ position, and elevating
the lower limbs during sleep.
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Hemorrhoids: Temporary symptomatic relief may be obtained by Sitz
baths and analgesic ointments. The
woman also should be instructed in how
to reinsert the hemorrhoid with a welllubricated finger, holding it in place for
1 to 2 min before releasing the pressure.
SEE: constipation.
Vaginal discharge: A normal increase
in vaginal discharge occurs during pregnancy. Common perineal hygiene usually is effective as a comfort measure;
douching is contraindicated during
pregnancy. The woman should contact
her primary caregiver promptly if profuse, malodorous, or blood-tinged discharge occurs. SEE: vaginitis.
Dyspnea: Shortness of breath occurs
as the growing uterus presses on the
woman’s diaphragm. Elevation of the
head and shoulders may provide some
relief. The dyspnea disappears when
lightening occurs.
Pruritus: The normal stretching of
the skin may generate itching on the
breasts, abdomen, and vulva. Pruritic
urticarial papules and plaques of pregnancy is the most common benign dermatosis of pregnancy. Occurring in the
third trimester, it usually resolves spontaneously after delivery. If severe, topical emollients, steriods, and, antihistamines may provide some relief. Use of
an emollient lotion may be suggested;
the patient is instructed to inform her
primary caregiver if vulvovaginal itching occurs in conjunction with an increase or alteration in vaginal discharge. SEE: vaginitis.
NUTRITION: A woman’s nutritional
status before and during pregnancy is
an important factor that affects both her
health and that of her unborn child. Nutritional assessment is an essential part
of antepartal care. In addition, the presence of pre-existing and coexisting disorders, such as anemia, diabetes mellitus, chronic renal disease, and
phenylketonuria, may affect dietary
recommendations. Substance abuse increases the risk of inadequate nutrition,
low maternal weight gain, low-birthweight infants, and perinatal mortality.
Dietary recommendations emphasize
a high-quality, well-balanced diet. Increased amounts of essential nutrients
(i.e., protein, calcium, magnesium, zinc,
and selenium, B vitamins, vitamin C, folate, and iron) are necessary to meet nutritional needs of both mother and fetus.
Most nutritional and metabolic needs
can be met by eating a balanced daily
diet containing approximately 35 kcal
for each kilogram of optimal body
weight plus an additional 300 kcal/day
during the second and third trimesters.
Because it is difficult to meet all the
daily dietary recommendations, vita-
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min and iron supplements are recommended.
CONSIDERATIONS: Travel during
pregnancy: Preparing for travel during
pregnancy will depend upon the number
of weeks gestation, the duration of the
travel, and the method (i.e., auto, boat,
bus, train, airplane).
Safety belts, preferably the combined
lap and shoulder type, should be worn
with the lap portion below the pregnant
abdomen not across it. If nausea and
vomiting of pregnancy is a factor, travel
by sea isn’t advisable. If anti-motionsickness medication is used, it should be
one approved for use during pregnancy
(or antinausea wrist bands may be
used). Travel during the last part of
pregnancy isn’t advised unless obstetrical care is available at the destination(s). It is important to have a copy of
current medical records along when
traveling. Travel abroad should be discussed with the obstetrician so that appropriate immunizations can be given.
For travel in an area known to be endemic for malaria, certain drugs will be
needed for prophylaxis.
Live virus immunization should
not be administered during pregnancy.
Working during pregnancy: Healthy
pregnant women who are employed in
jobs that present no more risk than
those in daily life are encouraged to continue working if they desire until
shortly before delivery.
Exercise during pregnancy: If the
pregnancy is progressing normally, exercise should be continued. The amount
and type of exercise is an individual
matter. A woman who has exercised
regularly before her pregnancy should
experience no difficulty with continuing;
however, a previously sedentary woman
should not attempt to institute a vigorous exercise program such as long-distance running or jogging during her
pregnancy. No matter what the type of
exercise, it is important to remember
that, with the progress of pregnancy,
the center of gravity will change and
probably prevent participation at the
same level and skill as before pregnancy. Sports to avoid include water
skiing, horseback riding, and scuba diving. In horseback riding, in addition to
the possibility of falling from the horse,
the repeated bouncing may lead to
bruising of the perianal area. Scuba diving may lead to decompression sickness
and bends and to intravascular air embolism in the fetus. Women who breastfeed their children should continue exercising if they maintain hydration and
adequate breast support.
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Sexual intercourse during pregnancy:
Women who are experiencing normally
progressing pregnancies need not avoid
intercourse. Pregnant women should refrain from coitus if they have a history
of preterm labor or premature rupture
of membranes and if they are bleeding
or have ruptured membranes.
Tests during pregnancy: Common
tests include blood tests for nutritional
or sickle cell anemia, blood type and Rh
factor, rubella titers, syphilis, and serum alpha-fetoprotein for the presence
of neural tube defects such as spina bifida. Additional testing may include determining HIV status and hepatitis immunity. Ultrasound may be used to
determine age, rate of growth, position,
some birth defects, and fetal sex. Chorionic villus sampling may be done early
in pregnancy if the family history indicates potential for genetic diseases. Second trimester amniocentesis may be
used to detect chromosomal abnormalities, genetic disorders, and fetal sex. In
late pregnancy, nonstress tests, contraction stress tests, and fetal biophysical
profiles may be done; amniocentesis
may be done to evaluate fetal lung maturity. SEE: table.
Pregnancy in adolescence: Although
pregnancy among teenagers is decreasing in the United States, about 7% of all
American teenage girls still become
pregnant in any given year— this is one
of the highest rates of teen pregnancy in
developed cultures. Sociocultural factors are believed to contribute to the
high incidence of pregnancies among
this population. Demographic data indicate that teen pregnancy is more
likely to be associated with being single,
having low socioeconomic status, and
lacking social support systems. Pregnant teenagers are believed to be at
high risk for some complications of preg-
Recommended Screening for
Pregnant Women
● Assessment of pregnant women for
alcohol misuse and tobacco use
● HIV antibodies (blood test)
● Chlamydia and gonorrhea (antigen
or culture) tests
● Hepatitis B virus (blood test)
● Rh incompatibility (blood test)
● Syphilis (blood test)
● Urinalysis for asymptomatic bacteriuria
● Nutritional assessment
● Assessment for intimate partner
violence
SOURCE: Adapted from the recommendations of the US Preventive Services Task
Force, Agency for Healthcare Research and
Quality, “The Guide to Clinical Preventive
Services 2006.”
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nancy; if, however, they seek prenatal
care early and consistently cooperate
with recommendations, the risk is comparable to that for other age groups.
Clinical data identify a common pattern
of late entry to the prenatal care system,
failure to return for scheduled appointments, and noncompliance with medical
and nursing recommendations. As a result of these behaviors, adolescents are
at higher risk for pregnancy-related
complications, such as iron-deficiency
anemia, pregnancy-induced hypertension, preterm labor and delivery, low
birthweight newborns, and cephalopelvic disproportion. Other health problems seen more commonly in pregnant
adolescents include sexually transmitted diseases and substance abuse. SEE:
high-risk pregnancy; Nursing Diagnoses
Appendix.
Mature pregnancy: A growing number
of women are experiencing their first
pregnancies after age 35. The incidence
of fetal demise among this population is
6:1000 births, double the rate for
women under 35. Many factors may contribute to the increased risk, including
pre-existing and coexisting conditions,
such as diabetes mellitus, hypertension,
and uterine fibroids. Mature women are
identified as being at higher risk for
spontaneous abortion, pre-eclampsia,
abruptio placentae, placenta previa,
gestational diabetes, cesarean birth,
and chromosomal abnormalities such as
Down syndrome. Multiple-gestation
secondary assisted reproduction also
may be a factor in fetal loss.
Pregnancy after menopause: Very
rarely, postmenopausal women have become pregnant through embryo donation and have successfully carried the
pregnancy to term delivery. Prior to undergoing this procedure, the women had
been taking hormone replacement therapy. Previously, it had been assumed
that the postmenopausal uterus would
not be capable of supporting the growth
and development of an embryo. Pregnancies in older women are considered
high risk for reasons similar to those related to mature pregnancy. Late in the
third trimester, the woman may be instructed to keep a fetal activity record
and undergo regularly scheduled nonstress tests.
abdominal p. Ectopic gestation in
which the embryo develops in the peritoneal cavity. SYN: abdominocyesis.
SEE: ectopic pregnancy.
ampullar p. Ectopic implantation of
the zygote in the ampulla of a fallopian
tube; 78% of all ectopic pregnancies occur in this site.
bigeminal p. Intrauterine twin gestation.
cervical p. Pregnancy with implan-
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tation of the embryo in the cervical canal.
coitus during p. Sexual intercourse
during pregnancy. There is no evidence
that this has adverse effects on the pregnancy or the embryo (i.e., perinatal mortality). Also, sexual intercourse does not
initiate labor.
cornual p. A rare type of ectopic
pregnancy (found in about 2% to 4% of
all ectopic pregnancies) in which implantation takes place in one of the
horns of the uterus. The uterine horn
may rupture between the 12th and 16th
week of gestation, causing life-threatening shock. Traditionally, cornual
pregnancies have been managed with
laparotomy and hysterectomy, although
conservative management strategies
are employed occasionally.
ectopic p. Extrauterine implantation of a fertilized ovum, usually in the
fallopian tubes, but occasionally in the
peritoneum, ovary, or other locations.
Ectopic implantation occurs in about 1
of every 150 pregnancies. Symptoms
usually occur between 6 and 12 weeks
after conception. SYN: extrauterine
pregnancy. SEE: illus; pregnancy.
SYMPTOMS: Early complaints are
consistent with those of a normal pregnancy (i.e., amenorrhea, breast tenderness, nausea). Pregnancy test results
are positive owing to the presence of human chorionic gonadotropin (hCG) in
blood and urine. Signs and symptoms
arise as the growing embryo distends
the fallopian tube; associated complaints include intermittent, unilateral,
colicky abdominal pain. Complaints associated with tubal rupture include
sharp unilateral pelvic or lower abdominal pain; orthostatic dizziness and vertigo or syncope; and referred shoulder
pain related to peritoneal irritation
from abdominal bleeding (hemoperitoneum). Signs of hypovolemic shock may
indicate extensive abdominal bleeding.
Vaginal bleeding, typically occurring after the onset of pain, is the result of decidual sloughing.
LOCATIONS: Abdominal: The incidence of pregnancy in the abdominal
cavity with the conceptus attached to an
abdominal organ is between 1:3000 and
1:4000 births. Ovarian: Conception and
implantation within the ovary itself occurs in approximately 1 in 7,000 to 1 in
50,000 pregnancies. Tubal: Ninety to
95% of ectopic pregnancies occur in the
fallopian tube; of these, 78% become implanted in the uterine ampulla, 12% in
the isthmus, and 2% to 3% in the interstices.
DIAGNOSIS:
Transabdominal or
transvaginal pelvic ultrasonography is
used to identify the location of the pregnancy. It has also largely replaced cul-
pregnancy
docentesis for confirmation of hemoperitoneum.
TREATMENT: An operative approach
is most common. Laparoscopy and linear laser salpingostomy can be used to
excise early ectopic implantations; healing is by secondary intention. Segmental resection allows salvage and later reconstruction of the affected tube.
Salpingectomy is reserved for cases in
which tubal damage is so extensive that
reanastomosis is not possible. Methotrexate has been used successfully to induce dissolution of unruptured tubal
masses less than 3.5 cm. Posttreatment
monitoring includes serial quantitative
b-hCG levels, to be certain that the
pregnancy has ended.
PATIENT CARE: Preoperative: The
patient is assessed for pain and shock.
Vital signs are monitored and oxygen
administration by nonrebreather mask
is started. An IV fluid infusion via a
large-bore cannula is started and blood
is drawn to type and cross (including
Rh-compatibility) for potential transfusion. Medications (including RhoGAM if
the patient is Rh negative) may be prescribed and administered and the patient’s response evaluated. The patient’s and family’s wishes regarding
religious rites for the products of conception are determined. Both patient
and family are encouraged to express
their feelings of fear, loss, and grief. Information regarding the condition and
the need for surgical intervention is
clarified.
Postoperative: Vital signs are monitored until stable, incisional dressings
are inspected, vaginal bleeding is assessed, and the patient’s physical and
emotional reactions to the surgery are
evaluated. Prescribed analgesics and
other medications are administered,
and the patient evaluated for desired
and adverse effects. The grieving process is anticipated, and both the patient
and family are referred for further counseling as needed. SEE: Nursing Diagnoses Appendix.
extrauterine p. Ectopic pregnancy.
false p. Pseudocyesis.
heterotopic p. Combined intrauterine and extrauterine pregnancies.
high-risk p. A pregnancy in which
maternal factors such as diabetes mellitus, hypertension, kidney disease, viral infections, vaginal bleeding, multiple pregnancies, substance abuse, age
under 17 or over 35, or toxic exposures
are present. Pregnancy in association
with these conditions is more likely to
compromise the health of the mother or
developing fetus than are normal pregnancies.
hydatid p. Pregnancy giving rise to a
hydatidiform mole. SEE: gestational
trophoblastic disease; hydatid mole.
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pregnancy
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OVARIES
VILLI INVADING
TUBAL WALL
HEMORRHAGE
IN TUBAL WALL
LUMEN OF
FALLOPIAN
TUBE
UTERUS
CHORION
AMNION
FETUS
ACTUAL ECTOPIC PREGNANCY
UTERUS
ISTHMIC
AMPULLAR
INTRALIGAMENTOUS
INFUNDIBULAR
FIMBRIAL
INTRAMURAL
OVARIAN
CERVICAL
ABDOMINAL
VARIOUS SITES OF ECTOPIC PREGNANCY
interstitial p. Rare condition in
which the zygote implants in the portion
of the fallopian tube that traverses the
wall of the uterus. SYN: mural p.
intraligamentary p. Pregnancy that
occurs within the broad ligament.
p. loss Miscarriage or stillbirth.
mask of p. Chloasma gravidarum.
membranous p. Pregnancy in which
the amniotic sac ruptures and the em-
bryo comes to lie in direct contact with
the uterine wall.
mesenteric p.
Tuboligamentary
pregnancy.
molar p. Pregnancy in which, instead of the ovum developing into an
embryo, it develops into a mole. SEE:
gestational trophoblastic disease; hydatid mole.
multifetal p. reduction In multiple
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pregnancies (e.g., triplets, quadruplets),
the procedure for reducing the number
of fetuses, to minimize the risk of maternal and fetal complications later in
the pregnancy.
multiple p. The presence of two or
more embryos in the uterus. If drugs are
not used to promote fertility, the incidence of natural twin pregnancies is 1:
94; however, 20% of women who have
undergone treatment with fertility
drugs develop multiple pregnancies. In
about one-half of twin pregnancies diagnosed by ultrasound early in the first
trimester, one twin will silently abort,
and this may or may not be accompanied by bleeding. This has been termed
the vanishing twin. The incidence of
birth defects in each embryo of a twin
pregnancy is twice that in singular
pregnancies. SEE: parabiosis.
mural p. Interstitial pregnancy.
ovarian p. Implantation of the embryo in the substance of the ovary.
phantom p. Pseudocyesis.
postdate p. Pregnancy that extends
beyond 42 wk of gestation. An average
of 10% of normal pregnancies are so
classified. SEE: post-term pregnancy;
postmaturity syndrome.
surrogate p. SEE: mother, surrogate.
tubal p. A form of ectopic pregnancy
in which the embryo develops in the fallopian tube.
tuboabdominal p.
Extrauterine
pregnancy in which the embryonic sac
is formed partly in the abdominal extremity of the oviduct and partly in the
abdominal cavity.
tuboligamentary p. Pregnancy occurring in the uterine tube and extending into the broad ligament. SYN: mesenteric pregnancy.
tubo-ovarian p. Extrauterine pregnancy in which the embryonic sac is
partly in the ovary and partly in the abdominal end of the fallopian tube.
uteroabdominal p. Twin pregnancy
with one embryo in the uterus and the
other in the abdominal cavity.
pregnancy-related death The death of a
woman occurring within 6 weeks after
pregnancy, conception, or termination
of pregnancy.
pregnancy-specific ␤1 glycoprotein A
protein found in 97% of women who
have been pregnant for 6 to 8 weeks and
in 100% of those at later stages of pregnancy. The function of this protein is not
known, but it may be useful in estimating the quality of placental function.
pregnancy test A test used to determine
whether conception has occurred. In addition to the clinical signs and symptoms of pregnancy, almost none of which
are reliable within the first several
weeks of pregnancy, chemical tests done
in the physician’s office are quite accurate by as early as the time the first
Prehn’s sign
menstrual period is missed. There are
also test kits available for purchase
without a prescription. If over-thecounter tests are used, it is very important to follow the directions carefully.
A major class of pregnancy tests is
those using immunodiagnostic procedures. They are the hemagglutination
inhibition test, which requires a sample
of urine; radioreceptor assay, which requires blood from the patient; radioimmunoassay, which requires a blood
sample; and monoclonal antibody determination, which requires a sample of
urine. In general, these tests are accurate beginning the 40th day following
the first day of the last menstrual period; the monoclonal antibody test is
somewhat more sensitive. The reliability of the test methods increases as
pregnancy continues.
pregnancy wheel A round calculator,
similar to a slide rule in its construction,
that uses the first day of the last menstrual period of a pregnant woman to
identify the expected date that her baby
will be born.
pregnane (prĕg⬘nān) C21H36; the organic
compound that is a precursor of two series of steroid hormones: the progesterones and several adrenal cortical hormones.
pregnanediol (prĕg⬙nān-dı̄⬘ŏl) C21H36O2;
the inactive end product of metabolism
of progesterone present in the urine.
The amount in the urine increases during the premenstrual or luteal phase of
the menstrual cycle and during pregnancy.
pregnanetriol (prĕg⬙nān-trı̄⬘ŏl) A metabolite of progesterone. Its presence in the
urine is increased in those who have
congenital adrenal hyperplasia.
pregnant (prĕg⬘nănt) [L. praegnans]
Having conceived; with child. SYN:
gravid.
pregnene (prĕg⬘nēn) A steroid that
forms the nucleus of progesterone.
pregravidic (prē-gră-vı̆d⬘ı̆k) [L. prae, before, in front of, ⫹ gravida, pregnant]
Before pregnancy.
prehallux (prē-hăl⬘ŭks) [⬙ ⫹ hallux, the
great toe] A supernumerary bone, accessory naviculare pedis, or sometimes
a prolongation inward of it on the foot.
prehemiplegic (prē⬙hĕm-ı̆-plē⬘jı̆k) [⬙ ⫹
Gr. hemi, half, ⫹ plege, a stroke] Occurring before an attack of hemiplegia.
prehensile (prē-hĕn⬘sı̆l) [L. prehendere,
to seize] Adapted for grasping or holding, esp. by encircling an object.
prehension (prē-hĕn⬘shŭn) [L. prehensio] The primary function of the hand;
includes pinching, grasping, and seizing.
Prehn’s sign (prānz, prēnz) A decrease in
scrotal pain with elevation of the testicle.
It is a physical finding in patients with
epididymitis and testicular torsion.
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prehormone (prē⬙ hawr⬘ mōn⬙) A precursor of a hormone.
prehospital care The care a patient receives from emergency medical service
before arriving at the hospital. This is
usually done by emergency medical
technicians and paramedics. SEE: outof-hospital.
prehospital care report ABBR: PCR.
The standardized form used by all
emergency medical service agencies
within an EMS system, to document patient care and assessments conducted in
the field.
prehospital provider A healthcare provider trained and certified or licensed by
the state, who practices emergency assessment and care in the out-of-hospital
setting. SEE: emergency medical technician; first responder; paramedic.
prehypertension (prē⬙hı̄-pĕr-tĕn⬘shı̆n) [⬙
⫹ ⬙] Having a systolic blood pressure
between 120 and 140 mm Hg or a diastolic blood pressure between 80 and 90
mm Hg. People with prehypertension
have an increased risk for strokes, heart
attacks, and kidney failure relative to
individuals whose blood pressure is below 120/80.
preictal (prē-ı̆k⬘tăl) [⬙ ⫹ ictus, stroke]
The period just prior to a stroke or convulsion.
preicteric (prē-ı̆k-tĕr⬘ı̆k) [⬙ ⫹ ikteros,
jaundice] In liver disease, the period
prior to the appearance of jaundice.
preimmunization (prē-ı̆m⬙ū-nı̆-zā⬘shŭn)
[⬙ ⫹ immunis, safe] Immunization
produced artificially in very young infants.
preimplantation (prē⬙ ı̆m-plăn-tā⬘ shŭn)
Before one thing is secured within another, e.g., before embedding of the blastocyst in the uterine wall.
preinvasive (prē⬙ı̆n-vā⬘sı̆v) [⬙ ⫹ in,
into, ⫹ vadere, to go] Referring to a
stage of development of a malignancy in
which the neoplastic cells have not metastasized.
Preiser’s disease (prı̄⬘zĕrz) [Georg K.F.
Preiser, Ger. orthopedic surgeon, 1879–
1913] Osteoporosis caused by trauma
and affecting the scaphoid bone of the
wrist.
prejudgment (prē-jŭj⬘mĕnt) [⬙ ⫹ ⬙]
Before a court rules. In malpractice litigation it refers to what occurred at the
time of an injury or at the date of filing
a claim.
prejudice 1. A preconceived judgment or
opinion formed without factual knowledge. 2. Irrational hostility, hatred, or
suspicion of a particular group, race, or
religion.
prekallikrein (prē-kăl-lı̆-krı̆n) A cofactor
in blood coagulation. SEE: coagulation,
blood.
preleukemia (prē-loo-kē⬘mē-ă) Myelodysplasia (1).
prelingual (prē-lı̆ng⬘gwı̆l) [⬙ ⫹ ⬙] Oc-
prematurity
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curring before the development and use
of speech and language.
preload (prē-lōd) In cardiac physiology,
the end-diastolic stretch of a heart muscle fiber. In the intact ventricle, this is
approx. equal to the end-diastolic volume or pressure. At the bedside, preload
is estimated by measuring the central
venous pressure or the pulmonary capillary wedge pressure. SEE: afterload.
premalignant (prē-mŭ-lı̆g⬘nı̆nt) [⬙ ⫹ ⬙]
Precancerous.
Premarin (prĕm⬘ı̆-rı̆n) SEE: conjugated
estrogen.
premature (prē-mă-chūr⬘) [L. praematurus, ripening early] Born or manifest
before full development has been
achieved.
premature
rupture
of
membranes
ABBR: PROM. In pregnancy, rupture
of the amniotic membrane prior to the
time labor was expected. This occurs in
about 10% of patients. PROM is the single most common diagnosis leading to
admission of the newborn to intensive
care nursing.
PROM is more common in women of
poor socioeconomic groups, teenagers,
single women, smokers, and women
who have a sexually transmitted organism cultured from the cervix or vagina
in the first half of pregnancy. PROM increases the risk of intrauterine infection.
preterm p.r.o.m. ABBR: PPROM.
Rupture of the fetal membranes before
completion of week 37 of pregnancy.
SEE: prematurity.
premature
ventricular
contraction
ABBR: PVC. The contraction of the cardiac ventricle prior to the normal time,
caused by an electrical impulse to the
ventricle arising from a site other than
the sinoatrial node. The PVC may be a
single event or occur several times in a
minute or in pairs or strings. Three or
more PVCs in a row constitute ventricular tachycardia.
prematurity
(prē-mă-chŭr-ı̆-tē)
The
state of an infant born any time prior to
completion of the 37th week of gestation. The normal gestation period for
the human being is 40 weeks. Because
of the difficulty of obtaining accurate
and objective data on the exact length of
gestation, a birth weight of 2500 g (5.5
lb) or less has been accepted internationally as the clinical criterion of prematurity regardless of the period of gestation. Other measures suggestive of
prematurity are crown-heel length (47
cm or less), crown-rump length (32 cm
or less), occipitofrontal circumference
(33 cm or less), occipitofrontal diameter
(11.5 cm or less), and ratio of the thorax
circumference to the head circumference (less than 93%).
The use of a single-criterion measure
(birth weight) imposes limitations in ac-
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curately identifying those infants born
before adequate development of body organs and systems has been achieved. It
can easily include mature infants who
are of low birth weight for reasons other
than a shortened gestation period. The
Expert Committee on Prematurity of
the World Health Organization (1961)
recommended that the concept of prematurity in the international definition
be replaced by that of low birth weight.
The term low birth weight more accurately describes infants weighing less
than 2500 g at birth than does the term
prematurity. The latter term should be
reserved for those neonates within the
low birth weight group with evidence of
incomplete development.
In the United States approx. 7.1%
white liveborn and 13.4% nonwhite liveborn infants weigh 2500 g or less.
Chances of survival depend on the degree of maturity achieved, general medical condition, and quality of care received.
Prematurity is the leading cause of
death in the neonatal period. Mortality
among infants weighing less than 2500 g
at birth is 17 times greater than among
infants with birth weight above 2500 g.
Chief causes of mortality are abnormal
pulmonary ventilation, infection, intracranial hemorrhage, abnormal blood
conditions, and congenital anomalies.
Antenatal steroids assist fetal lung development.
ETIOLOGY: The incidence of neonates of low birth weight is more frequent among the female sex, nonwhite
races, plural births, and the first- and
fifth- (and over) born infants. Delivery
of infants of low birth weight is reported
to be more frequent among women with
one or more of the following characteristics: having their children at either a
very young age or between ages 45 and
49; being unmarried; having children
closely spaced (i.e., less than 2 to 4 years
between births); and living in a large urban area.
Another factor associated with low
birth weight is the socioeconomic status
of the family as measured by the
mother’s educational attainment. The
proportion of infants of low birth weight
born to mothers with 16 years or more
of education was half of that of infants
born to mothers with less than 9 years
of education. Low birth weight is also
associated with generally elevated risk
of infant mortality, congenital malformations, mental retardation, and various other physical and neurological impairments.
COMPLICATIONS: Frequently, premature infants are handicapped by a
number of anatomical and physiological
limitations. These limitations vary in
direct proportion to the degree of im-
prematurity
maturity present. Limitations include
weakness of the sucking and swallowing
reflexes, small capacity of stomach, impairment of renal function, incomplete
development of capillaries of the lungs,
immature alveoli of the lungs, weakness
of the cough and gag reflexes, weakness
of the thoracic cage muscles and other
muscles used in respiration, inadequate
regulation of body temperature, incomplete or poorly developed enzyme systems, hepatic immaturity, and deficient
placental transfer and antenatal storage of minerals, vitamins, and immune
compounds. Severely premature infants
have high rates of neurological deficits
later in life. SEE: intrauterine growth
retardation; premature rupture of membranes.
PATIENT CARE: Ideally, the premature birth should take place in a regional intensive care center rather than
a community health facility so that especially prepared staff are available to
manage the birth and the premature infant, eliminating the need for infant
transfer and maternal-child separation.
A resuscitation team should be in attendance to take immediate charge of
the neonate. A physical assessment correlated with the expected maturation
for fetal age is performed. Health care
providers perform a neurological evaluation, obtain an Apgar score, ensure
proper environmental temperature,
provide proper fluid and caloric intake,
ensure parental bonding and support,
assess laboratory reports, monitor intake and output, notify the pediatrician
and nursery of the (impending) premature birth, weigh the infant daily at the
same time without clothing and on the
same scale, monitor oxygen concentration at frequent intervals, hold and cuddle the infant during feedings, cover the
infant when removing from isolette, and
provide adequate time for feeding.
Care of low-birth-weight infants: Care
of low-birth-weight infants should be individualized and reflect the needs of the
developing infant with regard to anatomical and physiological handicaps.
Evaluation for degree of immaturity
and identification of special problems
after birth dictates care required by
these infants. In general, care centers
on prevention of infection, stabilization
of body temperature, maintenance of
respiration, and provision of adequate
nutrition and hydration.
Aseptic technique is required. An incubator or heated bed provides a suitable environment for maintenance of
body temperature. A high-humidity environment may be of value for infants
with respiratory difficulties. Gentle nasal and pharyngeal suctioning aids in
keeping airways clear. Use of oxygen
should be restricted to the minimal
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amounts required for survival of the infant. Because of the danger of retrolental fibroplasia, the oxygen concentration
should not exceed 30%.
Depending on the infant’s sucking
and swallowing abilities, gavage feeding may be necessary. Some infants may
not be given anything by mouth for as
long as 72 hr after birth. Caloric and
fluid intakes are increased gradually
until 100 to 120 cal/kg and 140 to 150
ml/kg, respectively, in 24 hr are
reached. The time required to achieve
these intake levels depends on the newborn’s condition. The infant may require
small, frequent feedings to cope with
the small capacity of the stomach, to
prevent vomiting and distention, and to
meet the body’s caloric and fluid requirements. Overfeeding should be
avoided. During the early days of life,
clyses are sometimes administered to
maintain adequate hydration. Breast
milk is the optimal nutritional choice.
The infant should not be allowed to
become fatigued from excessive handling, prolonged feeding procedures, or
too much crying. Body position should
be changed every 2 to 4 hr. Gentle handling should be practiced. The newborn
and infant should receive cuddling and
pleasant vocal stimulation several
times a day.
Because of the possibility of retinal
damage, premature infants should not
be exposed to bright light. Parents are
kept informed of their infant’s condition, and equipment, procedures, and
treatments used are explained. They
are encouraged to visit, stroke and
touch, and then hold and feed the neonate as this becomes possible. Home
health care may be required to assist
the parents in caring for special needs
when the neonate is ready for discharge.
premaxilla (prē⬙măk-sı̆l⬘ă) [L. prae, before, in front of, ⫹ maxilla, jawbone]
A separate bone, derived from the median nasal process embryologically, that
fuses with the maxilla in humans; formerly called the incisive bone.
premedication (prē⬙mĕd-ı̆-kā⬘shŭn) [⬙
⫹ medicari, to heal] 1. Administration
of drugs before treatment to enhance
the therapeutic effect and safety of a
given procedure. 2. Preanesthetic.
premenarchal (prē⬙mĕ-năr⬘kăl) [⬙ ⫹
Gr. men, mouth, ⫹ arche, beginning]
The time prior to the first menstrual period (i.e., prior to menarche).
premenstrual (prē-mĕn⬘stroo-ăl) [⬙ ⫹
menstruare, to discharge the menses]
Before menstruation.
premenstrual dysphoric disorder ABBR:
PMDD. A disorder characterized by
symptoms such as markedly depressed
mood, anxiety, affective lability, and decreased interest in activities. It is the
current term, according to DSM-IV, for
premenstrual dysphoric disorder
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what was previously known as premenstrual tension syndrome, now PMDD.
Although the term premenstrual syndrome also is commonly used, it is not
the technical term for this disorder, but
may be used to identify a milder and
less debilitating form of the disorder.
SYN: premenstrual tension syndrome.
SYMPTOMS: In patients with this
disease, the symptoms occur regularly
during the last week of the luteal phase
in most menstrual cycles during the
year preceding diagnosis. These symptoms begin to remit within a few days of
the onset of the menses (the follicular
phase) and are always absent the week
following menses.
DIAGNOSIS: Five or more of the following symptoms must be present most
of the time during the last week of the
luteal phase, with at least one of the
symptoms being one of the first four:
feeling sad, hopeless, or self-deprecating; feeling tense, anxious, or “on edge”;
marked lability of mood interspersed
with frequent tearfulness; persistent irritability, anger, and increased interpersonal conflicts; decreased interest in
usual activities, which may be associated with withdrawal from social relationships; difficulty concentrating; feeling fatigued, lethargic, or lacking in
energy; marked changes in appetite,
which may be associated with binge eating or craving certain foods; hypersomnia or insomnia; a subjective feeling of
being overwhelmed or out of control;
and physical symptoms such as breast
tenderness or swelling, headaches, or
sensation of bloating or weight gain,
with tightness of fit of clothing, shoes,
or rings. There may also be joint or muscle pain. The symptoms may be accompanied by suicidal thoughts.
The pattern of symptoms must have
occurred most months for the previous
12 months. The symptoms disappear
completely shortly after the onset of
menstruation. In atypical cases, some
women also have symptoms for a few
days around ovulation; and a few
women with short cycles might, therefore, be symptom-free for only 1 week
per cycle. Women commonly report that
their symptoms worsen with age until
relieved by the onset of menopause.
TREATMENT: The selective serotonin
reuptake inhibitors, such as fluoxetine
and sertraline, but not tricyclic antidepressants, help improve symptoms of
the disorder for many patients. Other
pharmacologic treatments include calcium and magnesium supplements,
vitamins, prostaglandin inhibitors,
NSAIDs, and diuretics. Some people believe that symptoms are diminished by
limiting one’s intake of salt, refined sugars, caffeine (e.g., in chocolate, colas,
and coffee), nicotine, alcohol, red meat,
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and animal fat, and increasing consumption of leafy green vegetables,
whole-grain cereals, vitamins B6 and E,
and complex carbohydrates. The hypothesis that dietary changes influence
PMDD, however, has not been rigorously tested.
PATIENT CARE: Support and reassurance are offered, and the woman is
informed about self-help groups (as
available) and encouraged to develop
her own resources to help her cope with
the syndrome.
premenstrual syndrome ABBR: PMS.
SEE: premenstrual dysphoric disorder.
premenstrual tension syndrome ABBR:
PTS. Premenstrual dysphoric disorder.
SEE: Nursing Diagnoses Appendix.
premenstruum (prē-mĕn⬘stroo-ŭm) [⬙
⫹ menstruus, menstrual fluid] The period of time prior to menstruation.
premise (prĕm⬘ı̆s) A proposition or starting point that is accepted as true or that
is agreed to be true. SEE: assumption.
premium (prē⬘mē-um) A payment made
periodically to a health care insurer in
exchange for benefits coverage (indemnity against future expenses).
premium support (prē⬘mē-ŭm sŭ-pŏrt⬘)
A form of health insurance coverage in
which a third party, such as an employer or the federal government, provides a fixed contribution to an employee’s health insurance costs. The
employee chooses the extent of coverage
(e.g., basic, catastrophic, dental, extensive) and how much he or she is willing
to pay to be insured.
premixed (prē⬙mı̆kst⬘) [⬙ ⫹ ⬙] Prepared in standard concentrations or
percentages before use. Insulins, e.g.,
may be pure (composed of either short
or long-acting varieties but not both), or
they may be combined to take advantage of the differing times of onset and
peak effect of two different agents. Premixed insulins are usually labeled with
two numbers, separated by a slash (/).
An insulin mixture that is half longacting and half rapid-acting is labeled
50/50; one that is 70% long-acting and
30% rapid-acting is labeled 70/30.
premolar (prē-mō⬘lĕr) [⬙ ⫹ moles, a
mass] One of the permanent teeth that
erupt to replace the deciduous molars.
They are often called bicuspid teeth, for
the maxillary premolars have two
cusps, whereas the mandibular premolars may have from one to three cusps.
They are located between the canine
and first molar of each quadrant of the
dental arches. SEE: dentition.
premonition (prĕm⬙ĕ-, prē-mĕ-nı̆sh⬘ŭn)
[L. praemonere, to warn beforehand] A
feeling of an impending event.
premonitory
(prē-mŏn⬘ı̆-tō-rē)
[LL.
praemonitorius] Giving a warning, as
an early symptom.
premonocyte (prē-mŏn⬘ō-sı̄t) [L. prae,
preoperative care
before, in front of, ⫹ Gr. monos, alone,
⫹ kytos, cell] An embryonic cell transitional in development prior to a monocyte.
premorbid (prē-mor⬘bı̆d) [⬙ ⫹ morbidus, sick] Prior to the development of
disease.
premyeloblast (prē-mı̄⬘ĕ-lō-blăst) [⬙ ⫹
Gr. myelos, marrow, ⫹ blastos, germ]
A precursor of the mature myeloblast.
premyelocyte (prē-mı̄⬘ĕl-ō-sı̄t) [⬙ ⫹ ⬙
⫹ kytos, cell] The cell that is the immediate precursor of a myelocyte.
prenarcosis (prē-năr-kō⬘sı̆s) [⬙ ⫹ Gr.
narkosis, a benumbing] Preanesthetic.
prenatal (prē-nā⬘tl) [⬙ ⫹ natalis, birth]
Before birth.
prenatal care The regular monitoring
and management of the health status of
the pregnant woman and her fetus during the period of gestation. Comprehensive care is based on a thorough review
of the woman’s medical, surgical, obstetrical and gynecological, nutritional,
and social history, and that of the family
for indications of genetic or other risk
factors. Laboratory analyses provide
important data describing the woman’s
current health status and indications
for treatment and anticipatory guidance. Periodic visits are scheduled to
evaluate changes in blood pressure,
weight, fundal height, fetal heart rate,
and fetal activity, and to assess for any
signs of emerging health problems. To
enable the patient’s active participation
in care and to facilitate early diagnosis
and prompt treatment of emerging
problems, emphasis is placed on anticipatory guidance and patient teaching.
The health care professional describes
and discusses nutrition and diet (including the importance of folate supplementation), self-management of common
minor complaints, and signs to report
promptly to the primary caregiver;
helps patients gain access to resources
available for preparation for childbirth,
breastfeeding, newborn care, and parenting; and provides support and counseling. SEE: pregnancy; prenatal diagnosis; table.
prenatal surgery Intrauterine surgical
procedures. These techniques have been
used to repair heart defects and anatomical defects of other organs. SEE:
prenatal diagnosis.
preobese (prē-ō-bēs⬘) The term used by
the World Health Organization for
“overweight.”
preoperative care (prē-ŏp⬘ĕr-ă-tı̆v) [⬙ ⫹
operatus, work] Care preceding an operation, including the medical evaluation of the risks of surgery, and the psychological adjustment of the patient.
PATIENT CARE: A history and physical examination are conducted, baseline vital signs assessed, ECG, chest
X-ray, hematologic studies, blood chem-
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Common Tests Performed Prenatally*
Name of test
Type of test
Alpha fetoprotein
Blood
Amniocentesis
Invasive
Beta strep culture
Vaginal swab
Blood type
Chlamydia
Blood
Cervical swab
Glucose tolerance testing
GC/Gonorrhea
Hemoglobin
Hepatitis B antigen
and/or antibody
Human immunodeficiency virus antibody
test
Pap test
Rubella antigen
Triple or quad marker
screen
Ultrasonography
Blood
Cervical swab
Blood
Blood
Blood
Cervical sample
Blood
Blood
What it reveals
Increased risk for fetus of Down
syndrome or neural tube defects,
such as meningomyelocoele
Genetic diseases such as Down syndrome
Colonization of the vagina with
group B beta streptococcus, a
source of neonatal sepsis
ABO blood type; Rh antigen
Infection with Chlamydia trachomatis
Gestational diabetes mellitus
Infection with Neisseria gonorrheae
Anemia (maternal)
Presence of chronic or active hepatitis
HIV/AIDS infection
Urinalysis
Urine
Varicella-Zoster antibody
VDRL, RPR, FTA-ABS,
others
Blood
Cancer of the uterine cervix
Immunity to German measles
Birth defects such as Down syndrome or spina bifida
Age of the fetus; multiple pregnancies; developmental abnormalities; quantity of amniotic fluid
Urinary tract infections; chronic
kidney disease
Immunity to chickenpox
Blood
Infection with syphilis
Radiologic, noninvasive
*Not all these tests are performed on all expectant mothers.
istries, and urinalysis obtained. A member of the anesthesia team meets with
the patient and planned anesthesia is
discussed. Drug and other allergies are
ascertained and documented, along
with any individualized patient limitations. Time to discuss the meaning of
the procedure with the patient and to
allow the patient to express concerns
and fears is essential. The patient
should be instructed to cough, breathe
deeply (splinting incision as necessary),
turn, and exercise the extremities at frequent intervals. Incentive spirometry,
antiembolitic and/or pneumatic leg
dressings, and any expected mobility
devices are demonstrated and use practiced as necessary. Expected post-operative treatment procedures also are described, and pain management is
explained. The operative site is prepared as prescribed; the gastrointestinal tract is prepared as indicated (restrict food and fluids as ordered). Rest
and sleep are promoted; laboratory results are reviewed; and preoperative
medications are administered as prescribed after ensuring that an informed
consent has been signed and the patient
has voided. The patient should perform
oral hygiene; remove dentures, if
present, as well as jewelry and makeup; and dress in a hospital gown. Proper
identification on the patient identification bracelet is verified. If the patient is
menstruating, the type of menstrual
protection used should be noted on the
chart. Usually only pads are used while
the patient is in surgery and during hospitalization. The patient’s tampons or
pads should be changed, at least every
4 to 6 hr in the case of tampons (if
agency policy permits their use).
The patient is provided guidance concerning the timing of prescribed activities, including when to return to work
and athletic endeavors, when sexual activity may be resumed, and whether
there will be postoperative restriction
on driving automobiles. If same-day
surgery with discharge to home is
planned, the patient is made aware that
transportation must be provided by a
reliable relative or friend, and that he/
she should not be alone in the home for
the first 24 hours.
preoptic area (prē-ŏp-tı̆k) The anterior
portion of the hypothalamus. It is above
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the optic chiasma and on the sides of the
third ventricle.
preosseous (prē⬙ŏs⬘ē-ŭs) [⬙ ⫹ ⬙] Relating to the formation of partly formed
bone made of developing cartilage or
connective tissue.
preoxygenation
(prē-ŏks⬙ı̆-jı̆-nā⬘shŭn)
1. The administration of high-flow oxygen to a patient before endotracheal intubation or suctioning of the upper airway. 2. Breathing of 100% oxygen via a
face mask by the fully conscious patient
before induction of anesthesia. Duration
is 2 to 7 min. In that time the nitrogen
is washed out of the lungs and is replaced by oxygen.
This same procedure is used for a
longer period of time in persons before
exposure to very low atmospheric pressure (e.g., aviators before flying to high
altitudes) or to very high atmospheric
pressure (e.g., divers descending to a
great depth in water). In both cases the
goal is to rid the body of nitrogen to prevent bends.
prep (prĕp) [Abbreviation of prepare or
preparation] 1. To prepare (a patient)
for a medical or surgical procedure.
2. Preparation of a patient for a medical
or surgical procedure. SEE: preoperative
care.
bowel p. The administration of a
clear liquid diet with laxatives, enemas,
or both, in anticipation of endoscopy of
the lower gastrointestinal tract to provide an optimal view of the bowel wall.
prepaid care Managed care in which a
patient or group contracts for all its
health care services in advance, instead
of paying for each service when it is delivered.
prepalatal (prē-păl⬘ă-tăl) [L. prae, before, in front of, ⫹ palatum, plate] Located in front of the teeth.
preparalytic (prē⬙păr-ă-lı̆t⬘ı̆k) [⬙ ⫹ Gr.
para, at the side, ⫹ lyein, to loosen]
Before the appearance of paralysis.
preparation (prĕp-ă-rā⬘shŭn) [L. praeparatio] 1. The making ready, esp. of a
medicine for use. 2. A specimen set up
for demonstration in anatomy, pathology, or histology. 3. A medicine made
ready for use.
cavity p. The removal of dental caries and the excavation of surrounding
dental structure to permit reconstruction of the tooth with dental restorative
materials.
chlorine p. A disinfectant solution
such as Dakin’s solution or Javelle water, made from hypochlorites in water.
corrosion p. In anatomical and pathology investigations, hollow organs
and structures such as vessels are filled
with a liquid substance that hardens.
Then the surrounding tissues are dissolved by use of suitable chemicals. This
leaves a cast of the structures.
heart-lung p. In animal studies and
prepotent
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in open-heart surgery, the use of devices
that take over the function of the heart
and lungs while those organs are being
treated or possibly replaced.
preparative regimen High doses of cancer chemotherapy and/or radiation therapy, used prior to bone marrow or cord
blood transplantation to eliminate the
recipient’s blood-forming cells. Very
high doses of drugs and/or radiation are
used to eliminate as many diseased cells
from the recipient’s marrow as possible.
As a result, the recipient’s normal blood
cells are also destroyed. Preparative
regimens temporarily make patients
immunodeficient, anemic, and platelet–
deficient. Immunocompetence and the
ability to form red cells and platelets are
restored to patients when the donated
stem cells they receive engraft, i.e., begin to repopulate and reproduce in the
marrow. Also known as conditioning
regimen.
preparedness (prē-pār⬘ĕd-nĕs) The capability, planning, and training needed
to respond to a crisis (e.g., a multiple casualty incident, chemical spill, or terrorist attack).
prepatellar (prē⬙pă-tĕl⬘ăr) [L. prae, before, in front of, ⫹ patella, pan] In
front of the patella.
prepatellar bursitis An inflammation of
the bursa anterior to the patella, with
accumulation of fluid. It may be seen in
those who have to kneel frequently or
continually while working. SYN: housemaid’s knee; carpetlayer’s knee. SEE: illus.
PREPATELLAR BURSITIS
prepatent (prē-pā⬘tĕnt) Before becoming
evident or manifest.
prepatent period The period between the
time of introduction of parasitic organisms into the body and their appearance in the blood or tissues.
preperception (prē⬙pĕr-sĕp⬘shŭn) [⬙ ⫹
percepitio, to perceive] The anticipation of a perception. This intensifies the
response to the perception.
preplacental (prē⬙plă-sĕn⬘tăl) [⬙ ⫹ placenta, a flat cake] Occurring prior to
formation of the placenta.
prepotent (prē-pō⬘tĕnt) [⬙ ⫹ potentia,
short
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preprandial
1884
power] Pert. to the greater power of one
parent to transmit inherited characteristics to the offspring.
preprandial (prē-prăn⬘dē-ăl) [⬙ ⫹ prandium, breakfast] Before a meal.
prepuberal, prepubertal (prē-pū⬘bĕr-ăl,
−tăl) [⬙ ⫹ pubertas, puberty] Before
puberty.
prepubescent (prē⬙pū-bĕs⬘ĕnt) [⬙ ⫹ pubescens, becoming hairy] Pert. to the
period just before puberty.
prepuce (prē⬘pūs) [L. praeputium, prepuce] Foreskin.
p. of the clitoris A fold of the labia
minora that covers the clitoris. SEE:
clitoris.
preputial (prē-pū⬘shăl) Concerning the
prepuce.
preputial gland SEE: under gland.
preputiotomy (prē-pū⬙shē-ŏt⬘ō-mē) [⬙ ⫹
Gr. tome, incision] Incision of the prepuce of the penis to relieve phimosis.
preretinal (prē-rĕt⬘ı̆-năl) [⬙ ⫹ retina,
retina] In front of the retina of the eye.
presacral (prē-sā⬘krăl) [⬙ ⫹ sacrum, sacred] In front of the sacrum.
presby- Combining form meaning old.
presbyacusia, presbyacousia (prĕz⬙bē-ăkū⬘sē-ă) [Gr. presbys, old, ⫹ akousis,
hearing] Presbycusis.
presbyatrics,
presbyatry
(prĕz-bēăt⬘rı̆ks, prĕz⬘bē-ăt-rē) [⬙ ⫹ iatrikos,
healing] An infrequently used synonym for geriatrics.
presbycardia (prĕz-bı̆-kăr⬘dē-ă) [⬙ ⫹
kardia, heart] Decreased functional capacity of the heart, as a result of agerelated muscular hypertrophy, loss of
myocytes, and decreased cardiac elasticity and compliance.
presbycusis, presbykousis
(prĕz-bı̆kū⬘sı̆s) [⬙ ⫹ akousis, hearing] Progressive loss of hearing with aging, typically resulting from sensorineural
hearing loss. It is the third most common disease of the elderly, after hypertension and arthritis, and can cause
significant social isolation. SYN: presbyacusia.
presbyope (prĕs⬘bē-ōp) [⬙ ⫹ ops, eye]
A person who is presbyopic.
presbyopia (prĕz-bē-ō⬘pē-ă) [⬙ ⫹ ops,
eye] The permanent loss of accommodation of the crystalline lens of the eye
that occurs when people are in their 40s,
marked by the inability to maintain focus on objects held near to the eye (i.e.,
at reading distance). SEE: farsightedness.
presbytiatrics (prĕz⬙bı̆-tē-ăt⬘rı̆ks) [⬙ ⫹
iatrikos, healing] Geriatrics.
prescribe (prē-skrı̄b⬘) [L. praescriptio,
prescription] To indicate the medicine
to be administered. This can be done
orally but is usually done by writing a
prescription or an order in the patient’s
hospital chart.
prescribing cascade The administration
of a new drug to a patient because of
prescription
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side effects produced by another prescription. Later prescriptions increase
the risk of further side effects, drug interactions, and patient harm. A prescribing cascade usually results from
the failure of the health care prescriber
to recognize a patient’s presenting illness as evidence of an adverse drug reaction. In many patients, but esp. in
those with diminished kidney or liver
function, side effects of drugs are a common cause of drug toxicity and hospitalization.
prescribing error (prē-skrı̄-bēng) An error in the choice or administration of
drugs for patients. Included are incorrect dose or medicine, duplicate therapy, incorrect route of administration,
or wrong patient. In one extensive study
of prescriptions written by physicians in
a tertiary-care teaching hospital, 0.3%
were erroneous and more than half of
these were rated as having the potential
for adverse consequences. Monitoring of
medications and patients is thought to
be helpful in limiting these errors.
prescription (prē-skrı̆p⬘shŭn) [L. praescriptio] A written direction or order for
dispensing and administering drugs. It
is signed by a physician, dentist, or
other practitioner licensed by law to
prescribe such a drug. Historically, a
prescription consists of four main parts:
1. Superscription, represented by the
symbol 嗱, which signifies Recipe, meaning “take”
2. Inscription, containing the ingredients
3. Subscription, directions to the dispenser how to prepare the drugs
4. Signature, directions to the patient how to take the dosage; the physician’s signature, address, and telephone number; the date; and whether
the prescription may be refilled. When
applicable, the physician’s Drug Enforcement Administration number must
be included. Many states also require
that the prescriber indicate on the prescription whether or not a generic drug
may be substituted for the trade name
equivalent.
In the U.S. each year about 3 billion
prescriptions are written in health care
offices, and still more are written for inpatients.
Unused prescription pads should
be kept in a secure place in order to
prevent their being misused or stolen.
Each prescription should be numbered
consecutively. One should never sign a
prescription blank in advance. The prescriber should use ink to prevent changes
being made and not use prescription pads
for writing notes or memos.
p. drug A drug available to the public
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prescription
1885
only upon prescription written by a physician, dentist, or other practitioner licensed to do so.
exercise p. An exercise schedule usually intended to increase the physical
fitness of a previously sedentary individual who has recently had a serious
illness such as myocardial infarction, or
who is physically fit and wants to know
the amount, frequency, and kind of exercise necessary to maintain fitness.
The prescription is individualized, taking into account the person’s age, the
availability of facilities and adequate
supervision, and health, particularly if
the person has had chronic diseases of
the heart or lungs. SEE: physical activity and exercise.
shotgun p. A prescription containing
many drugs, given with the hope that
one of them may prove effective; it is not
a recommended approach to the treatment of disease.
prescriptive authority (prē-skrı̆p-tı̆v)
The limited authority to prescribe certain medications according to established protocol. In the U.S., prescriptive
authority has been granted to advanced
practice nurses, optometrists, osteopaths, physicians, podiatrists, and veterinarians among other health care professionals.
presenile (prē-sē⬘nı̄l) [L. prae, before, in
front of, ⫹ senilis, old] Occurring before the expected onset of age-related
changes, that is, in middle age. The
word is usually used to describe dementia that occurs relatively early in life.
presenium (prē-sē⬘nē-ŭm) [⬙ ⫹ senium,
old age] The time of life that precedes
old age, typically the years before age
65.
present (prē-zĕnt⬘) [L. praesent, to be
present before others] The presence of
the patient for examination.
presentation (prē⬙zĕn-tā⬘shŭn) [L. praesentatio] 1. In obstetrics, the position of
the fetus presenting itself to the examining finger in the vagina or rectum
(e.g., longitudinal or normal and transverse or pathologic presentation). 2. The
relationship of the long axis of fetus to
that of the mother; also called lie. SEE:
illus.; position for table. 3. The fetal
body part that first enters the maternal
pelvis. SEE: position for table.
breech p. Fetal position in which the
buttocks comes first. Breech presentation is of three types: complete breech,
when the thighs of the fetus are flexed
on the abdomen and the legs flexed
upon the thighs; frank breech, when the
legs of the fetus are extended over the
anterior surface of the body; and footling, when a foot or feet present. Footling can be single, double, or, if the leg
remains flexed, knee presentation.
SYN: pelvic presentation.
brow p. Fetal position in which the
pressor
brow or face of the infant comes first
during labor, making vaginal delivery
almost impossible. Cesarean section
may be needed if the presentation cannot be altered.
cephalic p. Presentation of the head
of the fetus in any position.
compound p. Fetal position in which
a prolapsed limb is alongside the main
presenting part.
face p. Fetal position in which the
head of the fetus is sharply extended so
that the face comes first.
footling p. Fetal position in which
the feet come first. SEE: breech p.
funic p. Appearance of the umbilical
cord during labor.
longitudinal p. Presentation in
which the long axis of the fetus is parallel to the long axis of the mother.
oblique p. Presentation in which the
long axis of the fetus is oblique to that
of the mother.
pelvic p. Breech presentation.
placental p. Placenta previa.
shoulder p. Presentation in which
the shoulder of the fetus is the presenting part.
transverse p. Presentation with the
fetus lying crosswise.
vertex p. Presentation of the upper
and back part of the fetal head.
presenteeism (prē⬙zĕn-tē⬘ı̆zm) [By analogy with absenteeism] Presence at
work without contributing to the productivity of the institution. The term is
used to describe such behavior as working while ill or distracted from one’s primary tasks, and thus in a less than fully
functional mode; or logging excessive
hours at work in an effort to impress coworkers or managers.
preservative (prē-zĕr⬘vă-tı̆v) [L. prae,
before, in front of, ⫹ servare, to keep]
A substance added to medicines or foods
to prevent them from spoiling. It may
act by interfering with certain chemical
reactions or with the growth of molds,
fungi, bacteria, or parasites. Some common preservatives are sugar, salt, vinegar, ethyl alcohol, sulfur dioxide, and
benzoic acid.
presphygmic (prē-sfı̆g⬘mı̆k) [⬙ ⫹ Gr.
sphygmos, pulse] Pert. to the period
preceding the pulse wave.
prespinal (prē-spı̄⬘năl) [⬙ ⫹ spina,
thorn] In front of the spine, or ventral
to it.
prespondylolisthesis (prē-spŏn⬙dı̆l-ō-lı̆sthē⬘sı̆s) [⬙ ⫹ Gr. spondylos, vertebra,
⫹ olisthanein, to slip] A congenital defect of both pedicles of the fifth lumbar
vertebra without displacement, predisposing the individual to spondylolisthesis.
pressor (prĕs⬘or) [O.Fr. presser, to press]
1. Stimulating, increasing the activity
of a function, esp. of vasomotor activity,
as a nerve. 2. Inducing an elevation in
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1886
pressoreceptive
pressoreceptor
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ATTITUDES OF THE FETUS
A
B
C
D
A —VERTEX PRESENTATION; B — SINCIPUT PRESENTATION;
C — BROW PRESENTATION; D — FACE PRESENTATION*
BROW PRESENTATION
A
B
A— ANTERIOR VIEW; B —SAGITTAL VIEW*
FACE PRESENTATIONS
L.M.A.
R.M.A.
R.M.P.
L.M.P.
LEFT MENTOANTERIOR (L.M.A.); RIGHT MENTOANTERIOR (R.M.A.);
RIGHT MENTOPOSTERIOR (R.M.P.); LEFT MENTOPOSTERIOR (L.M.P.)*
*Reproduced with permission from Bonica, J.: Principles and Practice of Obstetric Analgesia and Anesthesia. F.A. Davis, Philadelphia, 1972.
PRESENTATIONS OF FETUS
blood pressure. 3. One of several drugs,
such as dopamine, epinephrine, and
norepinephrine, that are used to increase the blood pressure of patients in
shock.
pressoreceptive (prĕs⬙ō-rē-sĕp⬘tı̆v) Sensitive to pressure stimuli. SYN: pressosensitive.
pressoreceptor (prĕs⬙ō-rē-sĕp⬘tor) Baroreceptor.
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1887
pressosensitive
pressure
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TYPES OF BREECH PRESENTATIONS
A
B
C
D
A — FRANK; B — COMPLETE; C — INCOMPLETE; D —FOOTLING*
TRANSVERSE PRESENTATION
A
B
A — RIGHT SCAPULOANTERIOR;
B — PROLAPSE OF AN ARM IN TRANSVERSE LIE*
SYNCLITISM (A) AND ASYNCLITISM (B AND C)
A
B
C
A. Sagittal suture of the fetus lies exactly midway between the symphysis
and the sacral promontory. B. Sagittal suture is close to the sacrum, and
the anterior parietal bone is felt by the examining finger (anterior asynclitism of Nägele's obliquity). C. Posterior parietal presentation of posterior
asynclitism (Litzmann's obliquity).*
*Reproduced with permission from Bonica, J.: Priniciples and Practice of Obstetric Analgesia
and Anesthesia. F.A. Davis, Philadelphia, 1972.
PRESENTATIONS OF FETUS
(CONTINUED)
pressosensitive (prĕs⬙ō-sĕn⬘sı̆-tı̆v) Pressoreceptive.
pressure (prĕsh⬘ŭr) [L. pressura] 1. A
compression. 2. Stress or force exerted
on a body, as by tension, weight, or pull-
ing. 3. In psychology, the quality of sensation aroused by moderate compression of the skin. 4. In physics, the
quotient obtained by dividing a force by
the area of the surface on which it acts.
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1888
pressure
alveolar p. Air pressure in the alveoli
and bronchial tree. It fluctuates below
and above atmospheric pressure during
breathing; this causes air to enter or
leave the lungs. SYN: intrapulmonic
pressure.
arterial p. The pressure of the blood
in the arteries. For a normal young person at physical and mental rest and in
sitting position, systolic blood pressure
averages about 120 mm Hg; diastolic
pressure about 80 mm Hg. A wide range
of normal variation is due to constitutional, physical, and psychic factors. For
women, the figures are slightly lower.
For older people, they are higher. Normally there is little difference in the
blood pressure recorded in the two
arms. SEE: blood pressure.
atmospheric p. The pressure of the
weight of the atmosphere; at sea level it
averages about 760 mm Hg.
bilevel positive airway p. ABBR:
BiPAP. A type of continuous positive
airway pressure in which both inspiratory and expiratory pressure are set.
blood p. SEE: blood pressure.
capillary p. The blood pressure in the
capillaries.
central venous p. ABBR: CVP. The
pressure within the superior vena cava.
It reflects the pressure under which the
blood is returned to the right atrium.
The normal range is between 5 and 10
cm H2O. A high CVP indicates circulatory overload (as in congestive heart
failure), whereas a low CVP indicates
reduced blood volume (as in hemorrhage or fluid loss). CVP can be estimated by examining the cervical veins
or the dorsal veins of the hand if the
neck and hand are at the level of the
heart. Those veins are well filled if CVP
is normal or high, and tend to collapse
if it is low.
cerebrospinal p. The pressure of the
cerebrospinal fluid. This varies with
body position but is normally about 100
to 180 mm H2O when the spinal canal
is initially entered during lumbar puncture with the patient lying on his or her
side.
continuous
positive
airway
p.
ABBR: CPAP. A method of ventilatory
support applied to the spontaneously
breathing patient in which airway pressure is maintained above atmospheric
pressure throughout the respiratory cycle. CPAP can be applied by way of a
nasal mask, a face mask, or an endotracheal tube. It can be used to treat congestive heart failure, acute pulmonary
edema, obstructive sleep apnea syndrome, and other conditions. A potential
adverse effect of CPAP is barotrauma to
the lungs.
cricoid p. The application of manual
pressure onto the cricoid cartilage during intubation and mechanical ventila-
pressure
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tion. This technique helps to occlude the
esophagus and prevent the entry of air
into the gastrointestinal tract during
ventilation. It also diminishes the
chances for regurgitation from the stomach and aspiration of gastric contents.
effective osmotic p. That portion of
the total osmotic pressure of a solution
that determines the tendency of the solvent to pass through a membrane, usually one that is semipermeable. The tendency is for the solvent to pass from a
solution containing a high concentration of the solute to the side of the membrane with the low concentration.
end-diastolic p. Blood pressure in a
ventricle of the heart at the end of diastole.
end-expiratory p. The pressure in
the lungs at the end of an exhaled
breath.
expiratory p. The pressure in the
lungs during the exhalation of a breath.
filling p. The average pressure in the
atria or the ventricles at the end of diastole.
hydrostatic p. The pressure exerted
by a fluid within a closed system.
increased intracranial p. An elevation of the pressure of the cerebrospinal
fluid. In healthy people intracranial
pressures range between 0 and 10 mm
Hg. Pressures higher than 20 mm Hg
increase the risk of compression or herniation of the brain or brainstem.
inspiratory p. The pressure in the
lungs during the inhalation of a breath.
intra-abdominal p. Pressure within
the abdominal cavity, such as that
caused by descent of the diaphragm.
intracranial p. The pressure of the
cerebrospinal fluid in the subarachnoid
space between the skull and the brain.
The pressure is normally the same as
that found during lumbar puncture.
intraocular p. ABBR: IOP. Fluid
pressure inside the eye; normally: 12 to
21 mm Hg.
intrapleural p. Pleural pressure.
intrapulmonic p. Alveolar pressure.
intrathoracic p. Pleural pressure.
intraventricular p. The pressure
within the ventricles of the heart during
different phases of diastole and systole.
jugular venous p. ABBR: JVP. Back
pressure exerted into the jugular veins
from the right side of the heart.
PATIENT CARE: To estimate jugular
venous pressure, have the patient lie on
his or her back with the chest, neck, and
head elevated 30 degrees above the horizontal. Measure the vertical height of
the fullness seen as the jugular vein
fills. In the healthy (and in the dehydrated) little or no blood is seen in the
jugular veins, and they appear to be flat.
In right-sided heart failure, the column
of blood distends the jugular veins to a
height of 5 to 6 cm or more.
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pressure
1889
negative p. Any pressure less than
that of the atmosphere, or less than that
pressure to which the initial pressure is
being compared.
oncotic p. Osmotic pressure exerted
by colloids in a solution.
opening p. ABBR: OP. The pressure
of the cerebrospinal fluid that is detected just after a needle is placed into
the spinal canal. It is normally 100 to
180 mm H20.
osmotic p. SEE: osmotic pressure.
partial p. In a gas containing several
different components, the pressure exerted by each component.
peak inspiratory p. The maximum
pressure in the lungs during inhalation.
plateau p. The average pressure in
the alveoli during the brief pause that
follows an inhaled breath.
pleural p. The pressure in the pleural
space, e.g., during mechanical ventilation or critical illness. It is normally
lower than atmospheric pressure and
therefore is sometimes called a negative
pressure. It is rarely measured, except
during mechanical ventilation, thoracentesis, or critical illness. SYN: intrapleural pressure; intrathoracic pressure.
positive p. Pressure greater than atmospheric or greater than the pressure
to which the initial pressure is being
compared.
positive end-expiratory p. ABBR:
PEEP. In respiratory medicine, a
method of holding alveoli open during
expiration. This is done by gradually increasing the expiratory pressure during
mechanical ventilation. When PEEP is
used, it is important to monitor the hemodynamic status of the patient because PEEP reduces venous return to
the heart and cardiac output. The goal
is to achieve adequate arterial oxygenation, without using toxic levels of oxygen and without compromising cardiac
output.
The patient must be carefully monitored to allow observation for undesired side effects such as pneumomediastinum, subcutaneous emphysema,
and pneumothorax.
positive end-expiratory p., auto
ABBR: auto-PEEP. A complication of
mechanical ventilation in which the
ventilator does not permit the patient
sufficient time to exhale. This causes air
to be trapped in the lungs, particularly
the alveoli. If continued, auto-PEEP
causes respiratory muscle fatigue and
can cause rupture of the lung (i.e., pneumothorax). Auto-PEEP may be corrected by increasing exhalation time,
decreasing the ventilator rate, or
switching the ventilation mode so that
the patient’s spontaneous respiratory
pressure sore
pattern governs the inspiratory and expiratory times.
posterior cricoid p. Pressure applied
by firmly placing the thumb and index
finger on the lateral aspects of a patient’s cricoid ring to occlude the esophagus. SYN: Sellick’s maneuver.
pulse p. The difference between systolic and diastolic pressures. The systolic pressure is normally about 40
points greater than the diastolic. A
pulse pressure over 50 points or under
30 points is considered abnormal.
solution p. Pressure that tends to
dissolve a solid present in a solution.
static p. 1. The pressure in the circulatory system between pulses.
2. Pressures that are present in a system when any variables that may impact the system are minimized.
systolic p. Systolic blood pressure.
transpulmonary p. Alveolar pressure minus pleural pressure. When normal transpulmonary pressures are exceeded, air leaks may develop.
venous p. The pressure of the blood
within the veins. It is highest near the
periphery, diminishing progressively
from capillaries to the heart. Near the
heart the venous pressure may be below
zero (negative pressure) owing to negative intrathoracic pressure.
wedge p. Pulmonary artery wedge
pressure.
pressure pain threshold ABBR: PPT.
The applied mass per area (kg/cm2) that
will elicit a complaint of pain in subjects
with painful conditions, e.g., fibromyalgia, temperomandibular joint dysfunction, or vulvodynia.
pressure point 1. A cutaneous area that
can be used for exerting pressure to control bleeding. For control of hemorrhage, pressure above the bleeding
point when an artery passes over a bone
may be sufficient. SEE: bleeding for table. 2. An anatomical location used in
shiatsu (acupressure) to relieve pain or
improve the health of organs or tissues.
equal p. p. During forced exhalation,
the point at an airway where the pressure inside the wall equals the intrapleural pressure. The pleural pressure
is greater than the pressure inside the
airway, tending to cause bronchiolar
collapse.
pressure sore Damage to the skin or underlying structures as a result of tissue
compression and inadequate perfusion.
Pressure ulcers typically occur in patients who are bed or chair bound. Patients with sensory and mobility deficits
(e.g., individuals with spinal cord injury, stroke, or coma); malnourished
patients; patients with peripheral vascular disease; hospitalized elderly patients; and nursing home residents are
all at risk. Some evidence also suggests
that incontinence is a risk factor.
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pressure of speech
The most common sites of skin breakdown are over bony prominences (i.e.,
the sacrum and the trochanters, the
heels, the lateral malleoli and also the
shoulder blades, ischial tuberosities, occiput, ear lobes elbows, and iliac crests).
The combination of pressure, shearing
forces, friction, and moisture leads to
tissue injury and occasionally necrosis.
If not treated vigorously, the ulcer will
progress from a simple red patch of skin
to erosion into the subcutaneous tissues, eventually extending to muscle or
bone. Deep ulcers often become infected
with bacteria and develop gangrene.
SEE: illus.
TREATMENT AND PREVENTION: The
most important principle of therapy is
to prevent the initial skin damage that
promotes ulceration. In patients at risk,
aggressive nursing practices, such as
frequent turning of immobile patients
and the application of skin protection to
bony body parts, frequently are effective. Gel flotation pads, alternating
pressure mattresses, convoluted foam
mattresses and sheepskins or imitation
sheepskins may be employed. Specialized air-fluid beds, waterbeds, or beds
with polystyrene beads provide expensive but effective prophylaxis as well. If
the patient develops an ulcer, topical
treatments with occlusive hydrocolloid
dressings, polyurethane films, absorbable gelatin sponges, collagen dressings,
wound-filter dressings, water-vapor
permeable dressings, and antibiotic
ointments (used only when infection is
confirmed by C&S testing) aid the healing of partial-thickness sores. Deeper lesions may need surgical débridement.
Skin-damaging agents such as harsh alkaline soaps, alcohol-based products,
tincture of benzoin, hexachlorophene,
and petroleum gauze should be avoided.
Consultation with a wound care specialist is advantageous.
PATIENT CARE: The skin is thoroughly cleansed, rinsed, and dried, and
emollients are gently applied by minimizing the force and friction used, esp.
over bony prominences. Patients who
PRESSURE SORE
presyncope
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are not able to position themselves are
repositioned every 1– 2 hours to prevent
tissue hypoxia resulting from compression. A turning sheet or pad is used to
turn patients with minimal skin friction. Care providers should avoid elevating the head of the bed higher than
30 degrees (except for short periods) to
reduce shearing forces on the skin and
subcutaneous tissues overlying the sacrum. Range-of-motion exercises are
provided, early ambulation is encouraged, and nutritious high-protein meals
are offered. Low-pressure mattresses
and special beds are kept in proper
working order. Doughnut-type cushions
should not be used because they decrease blood flow to tissues resting in
the center of the doughnut.
Ulcers are cleansed and débrided, and
other therapeutic measures are instituted according to institutional protocol
or prescription. Consultation with a nutritionist may be needed to assess and
optimize the patient’s nutritional
status, and to provide high protein
meals with added vitamin C to promote
healing, protein and calorie-rich supplements, or enteral feedings. Weak or debilitated patients should be assisted to
eat, with care taken to prevent swallowing difficulties. SYN: decubitus ulcer.
SEE: table; Nursing Diagnoses Appendix.
pressure of speech Loud and emphatic
speech that is increased in amount, accelerated, and usually difficult or impossible to interrupt. The speech is not
in response to a stimulus and may continue even though no one is listening. It
may be present in manic episodes, organic brain disease, depression with agitation, psychotic disorders, and sometimes as an acute reaction to stress.
pressure-time product ABBR: PTP. An
estimate of respiratory muscle oxygen
consumption during breathing. The
PTP is sometimes represented mathematically as the integral of the esophageal and chest wall static recoil pressure curves. It estimates the work done
when the diaphragm moves and estimates the oxygen consumption when
respiratory muscles contract isometrically but fail to move the chest wall or
the diaphragm.
presuppurative (prē-sŭp⬘ū-rā⬙tı̆v) [⬙ ⫹
sub, under, ⫹ puris, pus] Relating to
the period of inflammation before suppuration.
presymptomatic
(prē⬙sı̆mp-tō-măt⬘ı̆k)
The state of health prior to the clinical
appearance of the signs and symptoms
of a disease.
presynaptic (prē⬙sı̆-năp⬘tı̆k) [⬙ ⫹ Gr.
synapsis, point of contact] Located before the nerve synapse.
presyncope (prē⬙sı̆ng⬘kă-pē) Near faint-
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presystole
preventive nursing
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The Norton Scale*
Physical
Condition
Mental
State
Activity
Good
Fair
4
3
Alert
Apathetic
4
3
Poor
2
Confused
Very bad
1
Stuporous
Mobility
4
3
2
Ambulatory
Walks with
help
Chairbound
1
Bedfast
1
2
Full
Slightly
limited
Very limited
Immobile
Incontinence
4
3
Not
Occasionally
4
3
2
Usually urinary
Double
2
1
1
* The patient is rated from 1 to 4 on the five risk factors listed. A score of ⱕ14 indicates risk
for decubitus ulcers, or pressure sores.
SOURCE: Doreen Norton, Rhoda McLaren, and A.N. Exton-Smith. An investigation of geriatric nursing problems in the hospital. London: National Corporation for the Care of Old
People (now the Centre for Policy on Ageing), 1962.
ing; the sensation that one is about to
pass out.
presystole (prē-sı̆s⬘tō-lē) [L. prae, before, in front of, ⫹ Gr. systole, contraction] The period in the heart’s cycle just
before the systole. SYN: perisystole.
presystolic (prē-sı̆s-tŏl⬘ı̆k) Before the
systole of the heart.
pretarsal (prē-tăr⬘săl) [⬙ ⫹ Gr. tarsos,
a broad flat surface] In front of the tarsus.
preterm (prē-tĕrm) In obstetrics, occurring prior to the 37th week of gestation.
SEE: premature.
preterm labor SEE: labor, preterm.
prethalamus (prē-thăl⬘ŭ-mŭs) [⬙ ⫹ ⬙]
Subthalamus.
pretibial (prē-tı̆b⬘ē-ăl) [⬙ ⫹ tibia, shinbone] In front of the tibia.
pretibial fever A form of leptospirosis
caused by one of the several serotypes of
the autumnalis serogroup. It is characterized by fever, a rash on the legs, prostration, splenomegaly, and respiratory
disturbances. SYN: Fort Bragg fever.
pretracheal (prē⬙ trā⬘ kē-ı̆l, prē-trā⬘kē-ı̆l)
[⬙ ⫹ ⬙] Anterior to the trachea.
pretreatment 1. A priming treatment
given before the main course of therapy
or the main chemical modification of a
substance. 2. Before therapy.
wastewater p. In environmental
practice, acting to attempt to eliminate,
reduce, or alter polluted water after it
enters the water treatment works.
pretympanic (prē⬙tı̆m-păn⬘ı̆k) [⬙ ⫹
tympanon, drum] Located in front of
the tympanic membrane.
preurethritis (prē⬙ū-rē-thrı̄⬘tı̆s) [⬙ ⫹ Gr.
ourethra, urethra, ⫹ itis, inflammation] Inflammation around the urethral orifice of the vaginal vestibule.
Prevacid (prĕ⬘vă-sı̆d) SEE: lansoprazole.
prevalence (prĕv⬘ă-lĕns) [L. praevalens,
prevail] The number of cases of a disease present in a specified population at
a given time. SEE: incidence.
prevention (prē-vĕn⬘shŭn) The anticipation and forestallment of harm, disease, or injury. preventive, adj. SEE:
preventive nursing; medicine, preventive.
primary p. Limiting the spread of illness to previously unaffected patients
or populations.
p. paradox A preventive measure
that brings benefits to the community at
large but affords little benefit to each
participating individual.
secondary p. Limiting the impact or
the recurrence of an illness in patients
already afflicted by it.
preventive (prē-vĕn⬘tı̆v) [ME. preventen,
to anticipate] Hindering the occurrence
of something, esp. disease. SEE: prophylactic (1).
preventive medicine SEE: under medicine; prevention; preventive nursing.
preventive nursing The branch of nursing concerned with preventing the occurrence of both mental and physical illness and disease. The nurse is an
essential part of the health care team
and has the opportunity to emphasize
and indeed implement health care services to promote health and prevent disease. Nursing expertise and general
professional competence can also be
used in supporting community action at
all levels for promoting public health
measures. There are three levels of preventive nursing:
Primary. Nursing care aimed at general health promotion. This includes
whatever intervention is required to
provide a health-promoting environment at home, in the schools, in public
places, and in the workplace by ensuring good nutrition, adequate clothing
and shelter, rest and recreation, and
health education (including sex education and, for the aging, realistic plans
for retirement). Areas of emphasis are
specific protective measures such as immunizations, environmental sanitation,
accident prevention, and protection
from occupational hazards. Changes in
lifestyle through behavior therapy,
though difficult, must be attempted
with respect to those areas known to
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represent major health risk factors (i.e.,
smoking, obesity, sedentary lifestyle,
improper diet, alcohol and drug abuse,
sexual promiscuity and not practicing
safe sex, and falls). Major efforts must
be made to prevent automobile accidents.
Secondary. Nursing care aimed at
early recognition and treatment of disease. It includes general nursing interventions and teaching of early signs of
disease conditions. Infectious diseases,
glaucoma, obesity, and cancer fall into
this category.
Tertiary. Nursing care for patients
with incurable diseases, and patient instruction concerning how to manage
those conditions and diseases. Parkinson’s disease, multiple sclerosis, and
cancer are conditions that lend themselves to tertiary prevention. The goal
is to prevent further deterioration of
physical and mental function, and to
have the patient use whatever residual
function is available for maximum enjoyment of and participation in life’s activities. Rehabilitation is an essential
part of tertiary prevention. SEE: preventive medicine; public health.
prevertebral (prē-vĕr⬘tē-brăl) [L. prae,
before, in front of, ⫹ vertebra, vertebra] In front of a vertebra.
prevertiginous (prē-vĕr-tı̆j⬘ı̆-nŭs) [⬙ ⫹
vertigo, a turning round] Giddiness or
dizziness rather than true vertigo.
previa, praevia (prē⬘vē-ă) [L.] Appearing before or in front of.
previable, pre-viable (prē⬙ vı̄⬘ ā-bı̆l) Pert.
to a fetus not sufficiently mature to survive outside the uterus.
previous abnormality of glucose intolerance A past history of either: diabetes
mellitus in pregnancy; impaired fasting
glucose; an abnormal oral glucose tolerance test; or postprandial hyperglycemia.
Prevnar (prĕv⬘năr) Pneumococcal sevenvalent conjugate vaccine
prevocational
evaluation
(prē-vōkā⬘shŭn-ăl) In rehabilitation, the assessment of those interests, aptitudes,
abilities, and behavioral traits that are
necessary for developing or performing
specific job skills.
Prevotella (prē-vō-tĕl⬘ ă) A genus of
gram-negative, rod-shaped, anaerobic
bacteria that colonizes the oral cavity
and genital organs. Members of the genus cause abscesses, blood-borne infections, genital infections, periodonitis,
and wound infections.
prezonular (prē-zōn⬘ū-lăr) Pert. to the
posterior chamber of the eye, the space
between the iris and ciliary zonule (suspensory ligament).
prezygotic (prē-zı̄-gŏt⬘ı̆k) [⬙ ⫹ zygotos,
yoked] Happening prior to fertilization
of the ovum.
priapism (prı̄⬘ă-pı̆zm) [LL. priapismus]
primary landing site
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Abnormal, painful, and continued erection of the penis caused by disease, occurring usually without sexual desire.
SEE: erection; gonorrhea.
ETIOLOGY: It may be due to lesions
of the cord above the lumbar region; turgescence of the corpora cavernosa without erection may exist. It may be reflex
from peripheral sensory irritants, from
organic irritation of nerve tracts or
nerve centers when libido may be lacking. It is sometimes seen in patients as
a complication of sickle cell disease or
acute leukemia. It can also be due to
medicines injected into the penis to promote erection.
stuttering p. Painful, recurrent attacks of priapism that last 2 to 6 hr. The
condition is seen in some patients with
homozygous sickle cell disease.
priapitis (prı̄-ă-pı̄⬘tı̆s) [Gr. priapos, phallus, ⫹ itis, inflammation] Inflammation of the penis.
prickly heat (prı̆k⬘lē) Miliaria rubra; an
inflamed papular or vesicular rash that
results when the flow of sweat from
sweat glands is blocked.
prickly pear cactus (prı̆k⬘lē păr kăk⬘tı̆s)
The fruit of any of the cacti of the genus
Opuntia, native to and a staple food in
Mexico and Central America. SYN: nopal.
-pril (prı̆l) A suffix used in pharmacology
to designate an angiotensin-converting
enzyme (ACE) inhibitor.
Prilosec (prı̄⬘lō-sĕk) SEE: omeprazole.
primal scene (prı̄⬘măl) In psychiatry,
the term for a child’s first observation of
sexual intercourse, real or imagined.
primary (prı̄⬘mă-rē) [L. primarius, principal] First in time or order. SEE: principal.
primary antiphospholipid antibody syndrome Antiphospholipid antibody syndrome that occurs in the absence of
other rheumatologic disorders.
primary care, primary health care Integrated, accessible health care, provided
where the patient first seeks medical assistance, by clinicians who are responsible for most of a patient’s personal
health care, including health maintenance, therapy during illnesses, and
consultation with specialists.
primary care provider ABBR: PCP. The
health care provider (i.e., the nurse
practitioner, physician’s assistant, or
physician) to whom a patient first goes
to address a problem with his or her
health.
primary cell In physical therapy, a device
consisting of a container, two solid conducting elements, and an electrolyte for
the production of electric current by
chemical energy.
primary health care Primary care.
primary landing site The first or most
common tissue to which a particular tumor is likely to metastasize.
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primary nursing The nursing practice
system in which the entire nursing care
of a patient is managed and coordinated
by one nurse for a 24-hr period. The
nurse is involved in, manages, and coordinates all aspects of the patient’s
care in that period. This includes scheduling of activities, tests, and procedures.
primary progressive aphasia ABBR:
PPA. A form of dementia marked by
the inability to recall the names of
things, to read, or to express oneself
with speech. The disorder gradually
worsens and may ultimately produce
other cognitive deficits. Early in the
course of the disease, other brain functions pertaining to daily living are preserved, e.g., understanding speech, correct social behavior, and practicing
hobbies. PPA is associated with nonspecific degeneration of neurons in the left
hemisphere of the brain.
primary sore The initial sore or hard
chancre of syphilis.
primary teeth The deciduous teeth, colloquially known as “baby teeth.”
primate (prı̄⬘māt) [L. primus, first] A
member of the order Primates.
Primates (prı̄-mā⬘tēz) An order of vertebrates belonging to the class Mammalia, subclass Theria, including the lemurs, tarsiers, monkeys, apes, and
humans. This order is most highly developed with respect to the brain and
nervous system.
prime (prı̄m) [L. primus, first] 1. The
period of greatest health and strength.
2. To give an initial treatment in preparation for either a larger dose of the
same medicine, or a different medicine.
primer (prı̄m⬘ ĕr) A sequence of nucleotides that starts the replication or transcription of a gene.
primigravida (prı̄-mı̆-grăv⬘ı̆-dă) [⬙ ⫹
gravida, pregnant] A woman during
her first pregnancy.
elderly p. A woman who is 35 years
of age or older and pregnant for the first
time. In the past, women were informed
that delaying childbearing until age 35
or more would greatly increase the
chance of an adverse outcome of pregnancy. A well-controlled study of the
outcome of first pregnancy in this age
group indicates little, if any, increased
risk of adverse fetal outcome. The
women themselves had significantly
more antepartum and intrapartum
complications than younger women.
The women studied were private patients who were predominantly white,
college educated, married, nonsmoking,
and had had excellent prenatal care.
primipara (prı̄-mı̆p⬘ă-ră) [⬙ ⫹ parere, to
bring forth, to bear] A woman who has
been delivered of one infant of 500 g (or
of 20 weeks’ gestation), regardless of its
viability.
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primiparous (prı̄-mı̆p⬘ă-rŭs) Pert. to a
primipara.
(prı̆m⬘ı̆-tı̆v) [L. primitivus]
Original; early in point of time; embryonic.
primitive neuroectodermal tumor Medulloblastoma.
primitive streak In embryology, the initial band of cells from which the embryo
begins to develop. These cells are at the
caudal end of the embryonic disk. It is
present at about 15 days after fertilization.
primordial (prı̄-mor⬘dē-ăl) [L. primordialis] 1. Existing first. 2. Existing in an
undeveloped, primitive, or early form.
primordium (prı̄-mor⬘dē-ŭm) pl. primordia [L., origin] The first accumulation
of cells in an embryo that constitutes
the beginning of a future tissue, organ,
or part. SYN: anlage.
primum non nocere (prı̄⬙mŭm nōn nō⬘sĕrā) [L.] “First do no harm,” the goal in
health care, of avoiding actions that
may worsen a patient’s disease or suffering. SEE: risk-benefit analysis.
princeps (prı̆n⬘sĕps) [L., chief] 1. Original; first. 2. The name of certain arteries
(e.g., princeps cervicis). 3. Chief, principal.
principal (prı̆n⬘sı̆-păl) 1. Chief. 2. Outstanding.
principle (prı̆n⬘sı̆-pl) [L. principium,
foundation] 1. A constituent of a compound representing its essential properties. 2. A fundamental truth. 3. An established rule of action.
active p. The portion of a pharmaceutical preparation that produces the
therapeutic action.
gastrointestinal p. An archaic term
used to denote hormones, such as cholecystokinin, gastrin, and secretin,
which are secreted by mucosal cells of
the gastrointestinal tract and absorbed
into the blood.
primitive
reality p. SEE: reality principle.
Prinivil (prı̆n⬘ı̆-vı̆l) SEE: lisinopril.
Prinzmetal’s angina (prı̆nz-mĕ-tăl) [Myron Prinzmetal, U.S. cardiologist, 19081987] Variant angina. SEE: under angina.
prion (prē⬘ŏn) A small proteinaceous infectious particle that is believed to be responsible for central nervous system
diseases (spongiform encephalopathies)
in humans and other mammals.
prion disease Any transmissible neurodegenerative disease believed to be
caused by a proteinaceous infectious
particle (also known as prion proteins,
or PrPs). PrPs change other cellular
proteins, producing intracellular vacuoles (“spongiform change”) that disrupt
the functioning of neurons. Included in
this group are Creutzfeldt-Jacob disease, Gerstmann-Strüssler-Scheinker
syndrome, kuru, and fatal familial insomnia in humans, mad cow disease
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prior authorization
1894
(bovine spongiform encephalopathy),
and scrapie in sheep and goats. Prion
diseases may be transmitted by hereditary changes in the gene coding PrP; by
contaminated biological agents such as
plasma or serum, human growth hormone, and organ transplants; and possibly, by eating the flesh of infected animals.
All
prion
diseases
are
characterized by a long incubation period, followed by a rapidly progressive
dementia.
prior authorization The approval by an
insurer or other third-party payor of a
health care service before the service is
rendered. This approval is required in
order for the insurer to pay the provider
for the service.
prism (prı̆zm) [Gr. prisma] A transparent solid, three sides of which are parallelograms. The bases, perpendicular
to the three sides, are triangles, and a
transverse section of the solid is a triangle. Light rays going through a prism
are deflected toward the base of the triangle and at the same time are split into
the primary colors.
enamel p. Enamel rod.
Maddox p.
Two base-together
prisms used in testing for cyclophoria or
torsion of the eyeball.
Nicol p. A prism made by splitting a
prism of Icelandic spar and rejoining
the cut surfaces. This causes the light
passing through to be split. Ordinary
light rays are reflected by the joined surfaces, and polarized light is transmitted.
Risley’s rotary p. A prism mounted
in a device that allows it to be rotated.
This is used in testing eye muscle imbalance.
prismatic (prı̆z-măt⬘ı̆k) 1. Shaped like a
prism. 2. Produced by a prism.
prismoid (prı̆z⬘moyd) [⬙ ⫹ eidos, form,
shape] Resembling a prism.
prismoptometer (prı̆z-mŏp-tŏm⬘ĕ-tĕr) [⬙
⫹ opsis, vision, ⫹ metron, measure]
A device for estimating abnormal refraction of the eye by using prisms.
privacy In the medical context, the rights
of a patient to control the distribution
and release of data concerning his or her
illness. This includes information the
patient has provided to the health care
professionals and all additional information contained in the chart, medical
records, and laboratory data. Failure to
observe this aspect of a patient’s rights
is classed as an invasion of privacy.
privacy officer (prı̄⬘vı̆-sē ŏf⬘ı̆-sı̆r) The
health care administrator responsible
for safeguarding patient confidentiality
at a clinic or hospital. Under regulations
of the Health Insurance Portability and
Accountability Act (HIPAA), the privacy
officer oversees institutional privacy
policies, procedures, and rules.
private patient A patient whose care is
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the responsibility of one identifiable
health care professional, usually a physician or dentist. The health care professional is paid directly, either by the
patient or by the patient’s insurer.
private practice The practice by a health
care professional, usually a physician or
dentist, in a setting in which the practice and the practitioner are independent of external policy control other
than ethics of the professional and state
licensing laws.
privilege (prı̆v⬘ı̆-lı̆j) [L. privilegium, law
affecting a single person, prerogative]
1. A right granted to a person in recognition of some special status, e.g., a
right to practice one’s profession in a
health care facility. 2. An immunity
from commonly imposed standards or
laws.
privileged communication Confidential
information furnished (to facilitate diagnosis and treatment) by the patient to
a professional authorized by law to provide care and treatment. In some states,
the person who has received this communication cannot be made to divulge
it. When this is the case, communication
between the patient and the recipient is
classed as privileged.
Information given by the patient with
the family present may not be considered privileged.
prn [L. pro re nata]; according to circumstances; as necessary. Frequently used
in prescription and order writing.
pro- [L., Gr. pro, before] Prefix indicating for, in front of, before, from, in behalf
of, on account of. SEE: also ante-; pre-.
proaccelerin (prō-ăk-sĕl-ĕr-ı̆n) The fifth
factor (factor V) in blood coagulation.
SEE: coagulation factor.
proagglutinoid (prō⬙ă-gloo⬘tı̆-noyd) An
agglutinoid having a greater affinity for
the agglutinogen than that possessed by
the agglutinin.
proal (prō⬘ăl) [Gr. pro, before] Concerning forward movement.
proanthocyanidin
(prō-ăn⬙thō-sı̄-ăn⬘ı̆dı̆n) A chemical in cranberry juice that
is believed to inhibit the adhesion of
Escherichia coli to the mucosa of the urinary tract.
proarrhythmia (prō-ă-rı̆th⬘mē-ă) An arrhythmia that is stimulated, provoked,
or worsened by drug therapy. proar-
rhythmic, adj.
probability 1. Likelihood. 2. The ratio
that expresses the possibility of the occurrence of a specific event. The probability of a tossed coin landing heads or
tails is one-half or 50% each. This 50%
probability remains the same every
time a coin is tossed. Probability ratios
based on sophisticated techniques are
used for estimating the chance of occurrence of diseases in a population and in
projecting vital statistics such as birth
and death rates.
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1895
proband (prō⬘ bănd⬙) [L. probare, to test]
The initial subject presenting a mental
or physical disorder and who causes a
study of his or her heredity in order to
determine if other members of the family have had the same disease or carry
it. SYN: index case; propositus.
probang (prō⬘băng) A slim, flexible rod
with a sponge or similar material attached to the end; used for determining
the location of strictures in the larynx
or esophagus and for removing objects
from the trachea. Medicines may also be
applied to these areas by use of this device.
probationer (prō-bā⬘shŭn-ĕr) A person
being evaluated while working during a
trial period, as a student nurse just after entering training.
probe (prōb) [L. probare, to test] An instrument, usually flexible, for exploring
the depth and direction of a wound or
sinus.
dental p. A dental instrument formally known as a periodontal probe.
Florida p. A periodontal probe connected to a computer that measures the
depth of periodontal pockets automatically.
heater p. A surgical instrument that
is advanced through an endoscope and
used to cauterize bleeding peptic ulcers.
The probe applies thermal energy directly to the bleeding vessel, and works
best when it is pressed forcefully onto
the lesion.
periodontal p. A fine-caliber probe,
calibrated in millimeters, designed and
used to measure the depth and extent of
the gingival sulcus and periodontal
pockets present.
probiotic (prō⬙bı̄-ŏ⬘tı̆k) [Gr. pro, on behalf of, ⫹ bios, life] Having favorable
or health-promoting effect on living cells
and tissues. For example, Lactobacillus
acidophilus present in the gastrointestinal tract is probiotic because its presence inhibits the growth of harmful bacteria such as Salmonella and Listeria.
probity (prō⬘ bı̆-tē, prŏb⬘) Rectitude, integrity, or honesty; a characteristic expected of professionals.
problem drinking The consumption of
any amount of alcohol that causes life
problems for the drinker. Issues related
to the unhealthy use of alcohol arise
when drinking compromises one’s job,
legal standing, social relationships, or
health. Problem drinking is often used
as a synonym for alcohol abuse or alcoholism.
problem-oriented medical record ABBR:
POMR. Method of establishing and
maintaining the patient’s medical
record so that problems are clearly
listed, usually in order of importance,
and a rational plan for dealing with
them is stated. These data are kept at
the front of the chart and are evaluated
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as frequently as indicated with respect
to recording changes in the patient’s
status as well as progress made in solving the problems. Use of this system
may bring a degree of comprehensiveness to total patient care that might not
be possible with conventional medical
records.
problem-oriented record ABBR: POR.
SEE: problem-oriented medical record.
problem-solving therapy ABBR: PST. A
form of brief psychotherapy (typically
lasting 10 sessions or less) in which patients are taught a structured approach
to recognizing problems and finding
workable solutions.
pro bono publico (prō bō⬘ nō pŭb⬘ lı̆-kō,
poob-) Rendered for the public good
(i.e., without financial reward).
procarboxypeptidase
(prō⬙kăr-bŏk⬙sēpĕp⬘tı̆-dās) The inactive precursor of
carboxypeptidase, which is activated by
trypsin.
procaryote (prō-kăr⬘ē-ōt) [Gr. pro, before, ⫹ karyon, nucleus] Prokaryote.
procedure (prō-sē⬘dūr) [L. procedere, to
proceed] A particular way of accomplishing a desired result.
Blalock-Hanlon p. SEE: BlalockHanlon procedure.
Burch p. SEE: Burch procedure.
staged p. Any operation undertaken
in two or more separate parts, with a
lull between the two stages to facilitate
tissue healing or clearance of infection.
procentriole (prō-sĕn⬘trē-ŏl) The early
form of the centrioles and ciliary basal
bodies in the cell. SEE: centriole.
procercoid (prō-sĕr⬘koyd) The first larval stage in the development of certain
cestodes belonging to the order Pseudophyllidea. It is an elongated structure
that develops in crustaceans.
process (prŏs⬘ĕs) [L. processus, going before] 1. A method of action. 2. The state
of progress of a disease. 3. A projection
or outgrowth of bone or tissue. 4. A series of steps or events that lead to
achievement of specific results.
acromial p. Acromion.
acromion p. Acromion.
alveolar p. The portion of the mandible and maxilla containing the tooth
sockets. SYN: alveolar bone.
articular p. of vertebra One of four
small, flat processes (two superior and
two inferior) by which vertebrae articulate with each other.
basilar p. The narrow part of the
base of the occipital bone, in front of the
foramen magnum, articulating with the
sphenoid bone. SYN: pars basilaris ossis
occipitalis.
caudate p. The process of the caudate lobe of the liver extending under
the right lobe.
ciliary p. One of about 70 prominent
meridional ridges projecting from the
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spinous p. of vertebrae The posteriormost part of a vertebra. This spine
projects back and serves as a point of
attachment for muscles of the back.
styloid p. 1. A pointed process of the
temporal bone, projecting downward,
and to which some of the muscles of the
tongue are attached. 2. A pointed projection behind the head of the fibula.
3. A protuberance on the outer portion
of the distal end of the radius. 4. An ulnar projection on the inner side of the
distal end.
transverse p. The process extending
laterally and dorsally from the arch of a
vertebra.
unciform p. 1. Long thin lamina of
bone from the orbital plate of the ethmoid articulating with the inferior turbinate. 2. The hook at the anterior end
of the hippocampal gyrus. 3. The
hooked end of the unciform bone.
uncinate p. of the ethmoid bone A
sickle-shaped bony process on the medial wall of the ethmoidal labyrinth below the concha.
vermiform p. Vermiform appendix.
vocal p. The process of the arytenoid
cartilage that serves for attachment of
the vocal cord.
xiphoid p. The lowest portion of the
sternum; a sword-shaped cartilaginous
process supported by bone. No ribs attach to the xiphoid process; however,
some abdominal muscles are attached.
The xiphoid process ossifies in the aged
SYN: ensiform p.; xiphisternum.
processing In radiology, the use of a developer, fixer, washer, and dryer to
change a latent film image or electrical
impulses to a visible image for interpretation.
daylight p. The use of an automatic
system that accepts radiographic film,
inserts it into the processor, and refills
the cassette without the need for a darkroom.
extended p. In mammography, an
increase of the development time or developer temperature to enhance image
contrast and/or lower the radiation dose
to the patient.
processor 1. In radiology, a machine that
helps to convert the latent image to a
visible image. It consists of a transporter, electrical system, temperature
control, circulation system, and dryer.
2. Tissue processor. 3. That portion of a
computer’s central processing unit that
analyzes and prepares information for
display.
prochondral (prō-kŏn⬘drăl) [⬙ ⫹ chondros, cartilage] Preceding the formation of cartilage.
procidentia (prō⬙sı̆-dĕn⬘shē-ă) [L.] Prolapse of the uterus.
procoagulant (prō⬙kō-ăg⬘ū-lĕnt) [⬙ ⫹ ⬙]
1. Speeding or promoting blood clotting
short
standard
1896
corona ciliaris of the choroid coat of the
eye to which the suspensory ligament of
the lens is attached. These have the
same structure as the rest of the choroid
and secrete aqueous humor, which
nourishes neighboring parts, the cornea, and lens.
clinoid p. Any of three pairs of bony
processes on the top of the body of the
sphenoid bone, overhanging the edges of
the sella turcica.
condyloid p. A posterior process on
the superior border of the ramus of the
mandible consisting of a capitulum and
neck. It articulates with the mandibular
fossa of the temporal bone. SEE: mandible for illus.
coracoid p. A beak-shaped process
extending upward and laterally from
the neck of the scapula. The coracoid
process is not part of any bone-to-bone
articulation although the coracoclavicular ligament holds the clavicle against
the acromium of the scapula. The muscles attaching to the coracoid process
are the pectoralis major, coracobrachialis, and the short head of the biceps
brachii. SEE: scapula.
coronoid p. 1. The process on the
proximal end of the ulna that forms the
anterior portion of the semilunar notch.
2. The process on the anterior upper end
of the ramus of the mandible that serves
for attachment of the temporalis muscle. SEE: mandible for illus.
ensiform p. Xiphoid process.
frontal p. An upward projection of
the maxilla that articulates with the
frontal bone; forms part of the orbit and
nasal fossa.
infraorbital p. The medially projecting process of the zygomatic bone that
articulates with the maxilla. It forms
the inferior lateral margin of orbit.
lacrimal p. A short process of the inferior concha that articulates with the
lacrimal bone.
lenticular p. A knob on the incus in
the middle ear that articulates with the
stapes.
mastoid p. SEE: mastoid process.
nursing p. SEE: nursing process.
odontoid p. A toothlike process extending upward from the axis and about
which the atlas rotates. SYN: dens.
olecranon p. Olecranon.
palatine p. A process extending
transversely from the medial surface of
the maxilla. With the corresponding
process from the other side, it forms the
major portion of the hard palate.
pterygoid p. The process of the sphenoid bone extending downward from the
junction of the body and great wing. It
consists of the lateral and medial pterygoid plates, which are fused at the top.
The top of the pterygoid process is
pierced by the pterygoid canal.
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
procoagulant factor
1897
(adj.). 2. Any agent that promotes blood
clotting (n.).
procoagulant factor (prō-kō-ăg⬘ū-lănt)
A lymphokine that can assume the role
of factor VIII, antihemophilic factor, in
coagulation cascade.
procollagen (prō-kŏl⬘ă-jĕn) [⬙ ⫹ kolla,
glue, ⫹ gennan, to produce] Precursor of collagen.
proconvertin (prō⬙kŏn-vĕr⬘tı̆n) Coagulation factor VII.
proconvulsive (prō-kŏn-vŭl⬘sı̆v) Able or
likely to provoke seizures.
procreate (prō⬘krē-āt) [L. procreare] To
beget; to be the parents of an infant.
procreation (prō⬙krē-ā⬘shŭn) The act or
state of conceiving and giving birth to
an infant. SYN: reproduction.
proct- SEE: procto-.
proctalgia (prŏk-tăl⬘jē-ă) [⬙ ⫹ algos,
pain] Pain in or around the anus and
rectum.
p. fugax Severe rectal or anal pain,
usually occurring in young men, possibly as a result of muscular spasms.
proctatresia (prŏk⬙tă-trē⬘zē-ă) [⬙ ⫹
atresis, imperforation] Imperforation
of the anus.
proctectasia (prŏk⬙tĕk-tā⬘sē-ă) [⬙ ⫹ ektasis, dilatation] Dilatation of the anus
or rectum.
proctectomy (prŏk-tĕk⬘tō-mē) [⬙ ⫹ ektome, excision] Excision of the rectum
or anus.
proctitis (prŏk-tı̄⬘tı̆s) [⬙ ⫹ itis, inflammation] Inflammation of the rectum
and anus that may be caused by sexually transmitted diseases (e.g., infections with herpes simplex virus,
Neisseria gonorrhoeae, Chlamydia trachomatis, and others); radiation injury
(e.g., after treatment of pelvic cancers);
inflammatory bowel disease (e.g., ulcerative colitis); allergy; trauma; or ischemia.
diphtheritic p. Proctitis caused by
diphtheria; a rare condition in a time
when vaccination against diphtheria is
routine.
dysenteric p. Proctitis resulting
from infectious diarrhea. It may produce ulcers and scarring of the rectum
and anus.
gonococcal p. Gonorrheal infection
around the rectum and anus.
traumatic p. Proctitis that results
from anal or rectal injury.
procto-, proct- Combining forms meaning anus, rectum.
proctocele (prŏk⬘tō-sēl) [Gr. proktos,
anus, ⫹ kele, tumor, swelling] A protrusion of the rectal mucosa into the vagina. SYN: rectocele.
proctoclysis
(prŏk-tŏk⬘lı̆-sı̆s)
[⬙
⫹
klysis, a washing] Hydration of patients using a continuous slow infusion
of fluids into the rectum and colon. The
treatment sometimes is used for pallia-
proctopexia
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tion of thirst in terminally ill patients
who cannot receive fluids by other
means. SEE: enteroclysis.
THERAPEUTIC EFFECT: This procedure has the following therapeutic effects: to supply fluid in postoperative
cases when fluids cannot be taken
otherwise; to supply the body with fluid
as in hemorrhage, vomiting, or diarrhea; to relieve thirst as in persistent
vomiting; and to lower body temperature by giving ice water enemas.
PATIENT CARE: Any hydrating solution may be used (saline, free water,
dextrose in water, etc.) depending on
the patient’s fluid or electrolyte needs.
After the bowel is evacuated, a catheter
is inserted approx. 40 cm into the bowel,
and fluids are given at 250 to 300 ml/hr
or less, depending on tolerance. If pain
or distention develop, treatment should
be discontinued.
proctococcypexia,
proctococcypexy
(prŏk⬙tō-kŏk-sı̆-pĕk⬘sē-ă, −kŏk⬘sı̆-pĕk⬙sē)
[⬙ ⫹ kokkyx, coccyx, ⫹ pexis, fixation]
Suture of the rectum to the coccyx.
proctocolitis (prŏk⬙tō-kō-lı̄⬘tı̆s) [⬙ ⫹ kolon, colon, ⫹ itis, inflammation] Inflammation of the colon and rectum.
proctocolonoscopy
(prŏk⬙tō-kō⬙lŏnŏs⬘kō-pē) [⬙ ⫹ ⬙ ⫹ skopein, to examine] Examination of the interior of
the rectum and colon.
proctocystoplasty
(prŏk⬙tō-sı̆s⬘tōplăs⬙tē) [Gr. proktos, anus, ⫹ kystis,
bladder, ⫹ plastos, formed] Plastic
surgery involving the rectum and bladder.
proctocystotomy (prŏk⬙tō-sı̆s-tŏt⬘ō-mē)
[⬙ ⫹ kystis, bladder, ⫹ tome, incision]
Incision into the bladder through the
rectum.
proctodeum (prŏk-tō-dē⬘ŭm) [⬙ ⫹ hodaios, a way] An ectodermal depression located caudally that, upon rupture
of the cloacal membrane, forms the anal
canal.
proctodynia (prŏk⬙tō-dı̆n⬘ē-ă) [⬙ ⫹
odyne, pain] Pain in the rectum or
around the anus.
proctologic (prŏk⬙tō-lŏj⬘ı̆k) [⬙ ⫹ logos,
word, reason] Concerning proctology.
proctologist (prŏk-tŏl⬘ō-jı̆st) [⬙ ⫹ logos,
word, reason] One who specializes in
diseases of the colon, rectum, and anus.
proctology (prŏk-tŏl⬘ō-jē) The phase of
medicine dealing with treatment of diseases of the colon, rectum, and anus.
proctoparalysis (prŏk⬙tō-păr-ăl⬘ı̆-sı̆s) [⬙
⫹ para, at the side, ⫹ lyein, to loosen]
Paralysis of the anal sphincter muscle.
proctoperineoplasty (prŏk⬙tō-pĕr⬙ı̆-nē⬘ōplăs⬙tē) [⬙ ⫹ perinaion, perineum, ⫹
plassein, to form] Plastic surgery of the
anus and rectum.
proctopexia,
proctopexy
(prŏk-tōpĕk⬘sē-ă, prŏk⬘tō-pĕk⬙sē) [⬙ ⫹ pexis,
fixation] Suture of the rectum to some
short
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#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
proctoplasty
1898
other part, for example, presacral fascia.
proctoplasty (prŏk⬘tō-plăs⬙tē) [⬙ ⫹
plastos, formed] Plastic surgery of the
anus or rectum.
proctopolypus (prŏk⬙tō-pŏl⬘ı̆-pŭs) [⬙ ⫹
polys, many, ⫹ pous, foot] Polyp of
the rectum.
proctoptosis (prŏk⬙tŏp-tō⬘sı̆s) [⬙ ⫹ ptosis, a dropping] Prolapse of the anus
and rectum. SEE: procidentia.
proctorrhagia (prŏk⬙tō-rā⬘jē-ă) [⬙ ⫹
rhegnynai, to burst forth] Bleeding
from the rectum.
proctorrhaphy (prŏk-tor⬘ă-fē) [⬙ ⫹ rhaphe, seam, ridge] Suturing of the rectum or anus.
proctorrhea (prŏk-tōr-ē⬘ă) [⬙ ⫹ rhoia,
flow] Mucous discharge from the anus.
proctoscope (prŏk⬘tă-skōp⬙) [⬙ ⫹ ⬙] An
instrument used to inspect the rectum
visually.
proctoscopy (prŏk-tŏs⬘kō-pē) Inspection
of the rectum with a proctoscope.
proctosigmoidectomy (prŏk⬙tō-sı̆g⬙moydĕk⬘tō-mē) [⬙ ⫹ sigma, Gr. letter S, ⫹
eidos, form, shape, ⫹ ektome, excision]
Surgical removal of the anus, rectum,
and sigmoid flexure of the colon.
proctosigmoiditis
(prŏk⬙tō-sı̆g⬙moydı̄⬘tı̆s) [⬙ ⫹ ⬙ ⫹ eidos, form, shape, ⫹
itis, inflammation] Inflammation of the
rectum and sigmoid.
proctosigmoidoscopy
(prŏk⬙tō-sı̆gmoyd-ŏs⬘kō-pē) Visual examination of
the rectum and sigmoid colon.
proctospasm (prŏk⬘tō-spăzm) [⬙ ⫹
spasmos, a convulsion] Rectal spasm.
proctostasis (prŏk⬙tō-stā⬘sı̆s) [⬙ ⫹ stasis, stoppage] Constipation resulting
from failure of the rectum to respond to
defecation stimulus.
proctostenosis (prŏk⬙tō-stĕn-ō⬘sı̆s) [⬙ ⫹
stenosis, act of narrowing] Stricture of
the anus or rectum.
proctostomy (prŏk-tŏs⬘tō-mē) [⬙ ⫹
stoma, mouth] Surgical creation of a
permanent opening into the rectum.
proctotome (prŏk⬘tō-tōm) [⬙ ⫹ tome,
incision] A knife for incision into the
rectum.
proctotomy (prŏk-tŏt⬘ō-mē) Incision of
the rectum or anus.
PATIENT CARE: The dressing is assessed frequently and the presence and
amount of bleeding and drainage are recorded. Dressings should be changed or
reinforced as prescribed by the physician. A T binder (female patients) or
split T binder (male patients) is advantageous to ensure proper placement of
the dressing. Pain is assessed and analgesia provided as prescribed. The
wound is assessed for infection, and antibiotics prescribed as needed.
proctovalvotomy (prŏk⬙tō-văl-vŏt⬘ō-mē)
[⬙ ⫹ L. valva, leaf of a folding door, ⫹
Gr. tome, incision] Incision of the rectal
valves.
proencephalus
top of rh
base of rh
procumbent (prō-kŭm⬘bĕnt) [L. procumbens, lying down] Prone.
procure (prō-kūr⬘) [L. procurare, to take
care of] To obtain (e.g., an organ from
a donor).
procursive (prō-kŭr⬘sı̆v) [L. procursivus]
Having an involuntary tendency to run
forward.
procurvation (prō⬙kŭr-vā⬘shŭn) [L. procurvare, to bend forward] A bending
forward.
prodigiosin (prō-dı̆j-ē-ō⬘sı̆n) A bright red
pigmented chemical synthesized by Serratia marcescens and several other bacteria. It is cytotoxic and antibacterial.
prodromal (prō-drō⬘măl) [Gr. prodromos, running before] Pert. to the initial
stage of a disease; the interval between
the earliest symptoms and the appearance of a rash or fever.
prodromal rash A rash that precedes the
true rash of an infectious disease.
prodrome (prō-drōm) pl. prodromes,
prodromata A symptom indicative of an
approaching disease.
prodrug (prō-drŭg) An inert drug that
becomes active only after it is transformed or metabolized by the body.
product (prŏd⬘ŭkt) [L. productum] Anything that is made; also, the resulting
compound after the reaction of two
chemical substances.
production (prō-dŭk⬘shŭn) Development or formation of a substance.
production pressure The perception that
productivity is the primary goal of an institution rather than the provision of
quality service. In health care institutions the pressure to move patients
quickly from one status or setting to another, or to maximize bed occupancy,
may sometimes take precedence over
attention to detail and the provision of
optimal care. To counteract such pressures, health care professionals must
communicate clearly and effectively
with each other, follow established safe
practices, have methods for reporting
errors, and have protocols that link providers of different organizational status.
productive (prō-dŭk⬘tı̆v) Forming, esp.
new tissue.
productive inflammation An infrequently used term for any inflammatory
process in which there is marked cellular proliferation (e.g., in proliferative
retinopathy).
product liability The debt that manufacturers and sellers owe the public for any
damages their products cause. In health
care, the U.S. Food and Drug Administration and applicable tort law regulate
the responsibility for consumer product
safety of medical devices, new technologies, prostheses and implants, telecommunications
machinery,
office
equipment, supplies, and drugs.
proencephalus (prō⬙ĕn-sĕf⬘ă-lŭs) [Gr.
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
proenzyme
1899
pro, before, ⫹ enkephalos, brain] A
deformed fetus in which the brain protrudes through a fissure in the frontal
area of the skull.
proenzyme (prō-ĕn⬘zı̄m) [⬙ ⫹ en, in, ⫹
zyme, a leaven] The inactive form of an
enzyme found within a cell, which, upon
leaving the cell, is converted into the active form, such as pepsinogen, which is
cleaved to pepsin by hydrochloric acid in
gastric juice.
proestrus (prō-ĕs⬘trŭs) The period preceding estrus in females, characterized
by development of ovarian follicles and
uterine endometrium.
professional (prō-fĕsh⬘ŭn-ăl) [ME. profession, sacred vow] Pert. to a profession.
p. misconduct Behavior that is professionally unsuitable, potentially dangerous to patients, incompetent, disruptive, abusive, or illegal.
nonphysician p. Nonphysician provider.
professionalism
(prŏ-fĕsh⬘ŏn-ăl-ı̆z⬙m)
1. The competence and skill expected
and required of a professional. 2. The
status, practice, and methods of a professional as opposed to an amateur (e.g.,
in sports or music). SEE: professional
competence.
professional liability The obligation of
health care providers or their insurers
to pay for damages resulting from the
provider’s negligent acts of omission or
commission in treating patients.
professional liability insurance A type of
insurance contract that provides compensation for a person or party injured
by a professional’s acts or omissions.
Two common types of policies are as follows: (1) Claims made. The claim for
damages by the injured party must be
made during the policy coverage period
in order for the professional to be covered and represented by the insurance
company. (2) Occurrence basis. The
claim for damages by the injured party
is covered by the insurance company as
long as the act of professional liability
occurs during the policy coverage period, even though the claim is filed after
the coverage period ends.
Professional Standards Review Organization ABBR: PSRO. Peer review at
the local level required by Public Law
92-603 of the U.S. for the services provided under the Medicare, Medicaid,
and maternal and child health programs funded by the federal government. The major goals of the PSRO program are as follows: to ensure that
health care services are of acceptable
professional quality; to ensure appropriate use of health care facilities at the
most economical level consistent with
professional standards; to identify lack
of quality and overuse problems in
profile
health care and improve those conditions; to attempt to obtain voluntary
correction of inappropriate or unnecessary practitioner and facility practices,
and, if unable to do so, recommend sanctions against violators.
profibrinolysin (prō⬙fı̄-brı̆-nō-lı̄⬘sı̆n) [Gr.
pro, before, ⫹ L. fibra, fiber, ⫹ Gr.
lysis, dissolution] The inactive precursor of the proteolytic enzyme fibrinolysin.
proficiency (prō-fı̆sh⬘ĕn-sē) [L. proficere,
to move forward, to accomplish] Expertise; skill.
proficiency test A formal assessment of
the quality of work. Proficiency tests for
health care personnel are commonly
performed in the clinical laboratory to
ensure that standard procedures are followed and that laboratory results are
reliable.
profile (prō⬘fı̄l) [L. pro, forward, ⫹ filare, to draw a line] 1. An outline of the
lateral view of an object, esp. the human
head. 2. A summary, graph, or table
presenting a subject’s most notable
characteristics. 3. A comprehensive history of the use of health care services.
SEE: practice p.
biophysical p. ABBR: BPP. A system of estimating current fetal status,
determined by analyzing five variables
via ultrasonography and nonstress testing. Fetal breathing movements, gross
body movement, fetal tone, amniotic
fluid volume, and fetal heart rate reactivity are each assigned specific values.
Each expected normal finding is rated
as 2; each abnormal finding is rated as
0. Scores of 8 to 10 with normal amniotic
fluid volume and a reactive nonstress
test (NST) indicate satisfactory fetal
status. A score of 6 with normal amniotic fluid volume requires reassessment
of a preterm fetus within 24 hr of delivery. Scores of less than 6 or a nonreactive NST indicate fetal compromise and
require prompt delivery. SYN: fetal biophysical p. SEE: Apgar score.
drug p. The unique characteristics of
a drug or class of drugs, including their
administration, absorption, metabolism, duration of action, toxicity, and interactions with foods or other medications.
fetal biophysical p. Biophysical profile.
iceberg p. Profile of a person with a
psychological outlook characterized by
more vigor and less tension, depression,
anger, fatigue, and confusion than is
found in others. This type of affect often
is found in elite athletes and others with
physically active lifestyles.
practice p. A performance-based
method of assessing the professional behaviors of individual practitioners. A
typical profile may include data about a
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short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
profile
prognosis
top of rh
base of rh
build, alopecia, thick and inelastic skin
that has brownish spots on it, delayed
dentition, high-pitched voice, prominent eyes, and infantile sex organs.
progestagen
(prō-jĕs⬘tŭ-jĕn)
[progesta(tional) ⫹ ⬙] A synthetic compound that mimics the physiological effects of progesterone.
progestational
(prō⬙jĕs-tā⬘shŭn-ăl)
1. Concerned with the luteal phase of
the menstrual cycle, immediately after
ovulation, at which time progesterone is
secreted, further preparing the endometrium for implantation of a fertilized
ovum. 2. Referring to the hormone progesterone and its actions. 3. Referring
to a drug with actions similar to progesterone.
progestational agent Progestin (1).
progesterone (prō-jĕs⬘tĕr-ōn) A steroid
hormone, C21H30O2, obtained from the
corpus luteum and placenta. It is responsible for changes in the endometrium in the second half of the menstrual cycle preparatory to implantation
of the blastocyst. It facilitates implantation by inhibiting uterine motility and
stimulates the development of the
mammary glands. Progesterone is used
to treat patients with menstrual disorders (secondary amenorrhea, abnormal
uterine bleeding, luteal phase deficiency) and to manage renal or endometrial carcinoma. In combination with
estrogen, it is used for contraception
and postmenopausal hormone replacement therapy. SYN: progestin (1).
progestin (prō-jĕs⬘tı̆n) 1. A corpus luteum hormone that prepares the endometrium for implantation of the fertilized
ovum.
SYN:
progesterone;
progestational agent. 2. Progestogen.
progestogen (prō-jĕs⬘tō-jĕn) Any natural or synthetic hormonal substance
that produces effects similar to those
due to progesterone.
proglossis (prō-glŏs⬘ı̆s) [Gr.] The tip of
the tongue.
proglottid (prō-glŏt⬘ı̆d) pl. proglottides
[Gr. pro, before, ⫹ glotta, tongue] A
segment of a tapeworm, containing both
male and female reproductive organs.
SEE: Cestoda; tapeworm.
prognathic (prŏg-nā⬘thı̆k) [⬙ ⫹ gnathos, jaw] Prognathous.
prognathism (prŏg⬘nă-thı̆zm) [⬙ ⫹ gnathos, jaw ⫹ −ismos, condition] Projection of the jaws beyond projection of the
forehead.
prognathous (prŏg⬘nă-thŭs) Having
jaws projecting forward beyond the rest
of the face. SYN: prognathic.
prognose (prŏg-nōs⬘) To predict the
course of a disease.
prognosis (prŏg-nō⬘sı̆s) [Gr., foreknowledge] Prediction of the course and end
of a disease, and the estimate of chance
for recovery.
short
standard
1900
practioner’s patients, their known illnesses, their drug therapies, their immunization history, hospitalization
rate, use of other services, and the cost
of specific aspects of their care. The profile of an individual practitioner’s performance could provide information
such as the number of his or her patients who are screened for cancer or diabetes mellitus, or the number of patients treated for a particular condition
who survive. The profile could be used
to further a practitioner’s education, to
influence future care patterns, to certify
or recertify health care providers, or to
assist decisions about the hiring, retention, or dismissal of professionals who
provide health care services. The outcome of establishing practice profiles
could help to increase the quality of
medical care and to provide patients the
opportunity of evaluating physicians.
The methods used to profile practice are
constantly evolving.
PULSES p. One of the first formal,
widely used scales to assess daily living
skills. PULSES is an acronym formed
by the domains measured: Physical condition, Upper extremity function, Lower
extremity function, Sensory, Excretory,
and psychosocial Status. SEE: activities
of daily living.
safety p. The chemistry, pharmacology, therapeutic effects, and adverse effects of an administered drug or other
substance.
profluvium (prō-floo⬘vē-ŭm) [L.] An excessive flow or discharge; a flux.
p. seminis The flow from the vagina
of semen deposited during coition.
profunda (prō-fŭn⬘dă) [L.] Deep seated;
term applied to certain deeply located
blood vessels.
profundaplasty (prō-fŭn⬘dă-plăs⬙tē) An
operation to repair an obstructing lesion
in a deep blood vessel, for example, of
the deep femoral artery.
profundus (prō-fŭn⬘dŭs) [L.] Located
deeper than the indicated reference
point.
progastrin (prō-găs⬘trı̆n) The inactive
precursor of gastrin.
progenitor (prō-jĕn⬘ı̆-tor) [L.] An ancestor.
progeny (prŏj⬘ĕ-nē) [ME. progenie] Offspring.
progeria (prō-jē⬘rē-ă) [Gr. pro, before, ⫹
geras, old age] The syndrome of premature aging, which may be an inherited disorder that is transmitted as an
autosomal dominant trait. The incidence appears higher in children of
older fathers. Onset is from birth to 18
months of age and the average age at
death is 12 to 13 years.
FINDINGS: The child has an aged
and wizened appearance. In addition
there is small stature, slightness of
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
prognosticate
prognosticate
1901
(prŏg-nŏs⬘tı̆-kāt)
[Gr.
prognostikon, knowing before] To make
a statement on the probable outcome of
an illness.
program A plan or system, usually
printed, outlining procedures or actions
to be followed.
employee benefit p. A group of economically useful goods or services workers receive from their employer in addition to salary. These often provide
protection against unpleasant or catastrophic events. Examples include medical and dental insurance, disability income, retirement income, and life
insurance.
Individualized Education P. ABBR:
IEP. A documented program of intervention mandated for each child provided education-related rehabilitation
services under federal legislation. The
program guarantees a free and appropriate public education for children with
disabilities. Decisions relating to Individual Educational Programs must be
approved in Admission, Review and
Discharge conferences mandated by federal legislation. Participants in these
conferences should include parents or
guardians, special educators, rehabilitation providers, and others as appropriate.
needle exchange p. Syringe exchange program.
preprosthetic p. Postsurgical intervention following amputation during
which the patient is taught stump care,
positioning, sitting tolerance, transfer
techniques, and other skills that are
necessary before prosthetic training can
begin.
prosthetic training p. Systematic education and training provided to persons with amputations following fitting
of a prosthetic device.
syringe exchange p. ABBR: SEP. A
public health program for collecting
used hypodermic syringes and exchanging them for sterile ones. Such programs are designed to decrease the
spread of diseases (like AIDS and hepatitis C) that are transmitted by the
sharing of contaminated needles.
PATIENT CARE: Syringe-exchange
programs not only reduce the spread of
blood-borne illnesses but also serve as
gateways to other vital medical services
for patients at risk (e.g., drug abusers
who want to stop, or pregnant women,
the mentally ill, malnourished, or those
who need vaccination). In its position
statement on needle exchange and HIV/
AIDS, the American Nursing Association states, “nurses support the availability of needle exchange programs
(that) include adherence to public
health and infection control guidelines,
access for referral to treatment and re-
progressive lens
top of rh
base of rh
habilitative services, and education
about the transmission of HIV disease.”
Health care professionals must be familiar with federal and state laws about
needle exchange. Most programs operate by providing a single sterile needle
for each contaminated needle brought
in by a client. Contaminated needles
brought to exchange programs are
treated as biomedical waste products
and are managed by these programs according to public health guidelines.
SYN: needle exchange program.
12-step p. A form of treatment, used
primarily by persons who abuse alcohol
or other substances, that relies on social
support, interpersonal motivation, abstinence from the addictive substance,
and spirituality.
program of all-inclusive care for elderly
ABBR: PACE. A form of capitation administered in the U.S. by the Centers
for Medicare and Medicaid Services in
which frail older adults receive adult
day care, outpatient or in-home medical
care, and social services. The goal of the
program is to foster independent living
by the elderly, thus decreasing institutionalization.
programming Making a set of instructions guiding the actions of a computer,
a piece of equipment, an organism, or a
research investigation.
progranulocyte (prō-grăn⬘ū-lō-sı̄t) [⬙ ⫹
L. granula, granule, ⫹ Gr. kytos, cell]
Promyelocyte.
progravid (prō-grăv⬘ı̆d) [⬙ ⫹ L. gravidus, pregnant] Preceding pregnancy.
progress [L. progressus, a going forward]
The ongoing sequence of events of an illness.
progression (prō-grĕsh⬘ŭn) [L. progressus] An advancing or moving forward.
progression-free Diseases, such as cancer, not advancing or becoming worse or
more symptomatic.
progressive (prō-grĕs⬘ı̆v) Advancing, as
a disease, from bad to worse.
progressive hemifacial atrophy A rare
disorder for which there is no treatment
usually affecting females in which
cheek tissues on one side of the face
gradually waste or deteriorate. The disease is often associated with local hair
loss and may be accompanied by seizures or trigeminal neuralgia. The progression usually lasts between 2 and 10
years, but then enters a stable phase, at
which time cosmetic surgery may be
possible. SYN: Parry-Romberg syndrome.
progressive lens An eyeglass lens that
gradually changes prescription strength
from the top of the lens, which is used
for viewing distance, to the bottom of
the lens, which is used for seeing objects
that are nearby. Progressive lenses enable the eyes to adjust from one distance
short
standard
#49016 - Venes: Taber’s Cyclopedia Medical Dictionary -- 21st Edition -- FA Davis
progressive ossifying myositis
1902
to another (e.g., when looking up from a
book) without the “image jump” associated with bifocals, lenses that require
the eye to shift between two separate
prescriptions.
progressive ossifying myositis A tendency to bony deposits in the muscles
with chronic inflammation.
progressive systemic sclerosis ABBR:
PSS. A chronic disease of unknown etiology that occurs four times as frequently in women as in men. It causes
sclerosis of the skin and certain organs
including the gastrointestinal tract,
lungs, heart, and kidneys. The skin is
taut, firm, and edematous and is firmly
bound to subcutaneous tissue, which often causes limitation of the range of motion; it feels tough and leathery, may
itch, and later becomes hyperpigmented. The skin changes usually precede the development of signs of visceral
involvement. A limited variant, called
the CREST syndrome, includes only the
following findings: calcinosis, Raynaud’s phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia.
TREATMENT: There is no specific
therapy. General supportive therapy is
indicated. A great number of drugs including corticosteroids, vasodilators, Dpenicillamine, and immunosuppressive
agents have been tried. Physical therapy will help maintain range of motion
and muscular strength but will not influence the course of joint disease.
progress notes An ongoing record of a
patient’s illness and treatment. Physicians, nurses, consultants, and therapists record their notes concerning the
progress or lack of progress made by the
patient between the time of the previous
note and the most recent note. In patients who are not critically ill, a note
concerning progress may be made daily
or less frequently; for patients in critical
care, notes may be made hourly. It is important that each note be clearly written, the date and time recorded, and the
note signed.
progress report The written or verbal account of a patient’s present condition,
esp. as compared with the previous
state.
prohapten (prō-hăp⬘tĕn) A chemical (often a drug) that does not stimulate an
immune response until it is metabolized
into an immunologically reactive form
by living cells.
prohormone (prō-hor⬘mōn) Precursor of
a hormone.
proinsulin (prō-ı̆n⬘sū-lı̆n) Precursor of
insulin produced in the beta cells